| NPI | 1982902284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDAL NMN BUTTS Owner 757-204-4463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 1106464) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |