| NPI | 1053314161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON SORENSEN President 615-890-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN 127397) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 127397) |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: TN 127397) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2022-01-18 |