| NPI | 1013563527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY GRIMSLEY CFO 601-496-9801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-08-12 |