| NPI | 1982890141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA BAILEY Owner/President 434-237-6812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 2305006068) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 2305006068) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: VA 2305006068) | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2012-08-08 |