| NPI | 1013077064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LINDSLEY Administrator 318-812-0119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-07-16 |