| NPI | 1033746961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANDRE S MOSTELLA Owner 225-316-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2023-09-06 |