| NPI | 1649392556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MICHAEL GUARRASI Owner 571-436-7389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: PR 165387) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: PR 165387) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-06-10 |