| NPI | 1982964292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BENTON SHENK Vice President/General Manager 757-728-3755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 2705 040492A) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |