Organization
CRIBCRAFTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD MEYER (OWNER)
(703) 338-0822
Entity
Organization
Contact information
Practice address
2206 CASTLE ROCK SQ APT 22C, RESTON, VA 20191-2206
(703) 338-0822
(703) 880-7058
Mailing address
2206 CASTLE ROCK SQ APT 22C, RESTON, VA 20191-2206
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
2705109387
VA
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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