| NPI | 1033583653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SOUTHALL SHELTON Prosthetist/Orthotist 910-520-0163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 222Z00000X Orthotist |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-12-01 |