| NPI | 1639570559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JACEK Manager 202-745-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: DC 400314900285) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: DC 400314900285) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |