| NPI | 1720689805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ARIETTA WISEMAN Member 304-345-8501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2023-01-16 |