| NPI | 1003308248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA M ASHFORD President 800-719-0061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: SC 55548) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-04 |