| NPI | 1922277854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE LYNN HOLDERBAUM Office Manager 740-622-0338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 2656) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: OH 2656) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: OH 2656) | |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2009-02-10 |