| NPI | 1063117810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE JOY DIAZ CEO 443-854-3307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-04-03 |