| NPI | 1053195446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM TYRRELL-KNOTT SVP/Chief Compliance Officer 866-356-7846 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2024-01-15 |