| NPI | 1942207121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE L DESARRO Administrative Director 814-452-4632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA 6000006121) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2012-09-24 |