| NPI | 1932499506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABEL COSTAS BORROMEO Managing Member 540-550-3656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: VA 0104556472) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: VA 0104556472) |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2018-02-01 |