| NPI | 1033552443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY RUSS President 512-202-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 101427) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2022-07-21 |