| NPI | 1023719275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INEZ TERRANCE Authorized Official 225-205-8635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2023-03-14 |