| NPI | 1922507870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN RODRIGUEZ Owner/CEO 804-484-0292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: VA 1204017518) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-12-21 |