| NPI | 1063931558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMEKA L FITZGERALD CEO 757-977-6491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 224P00000X Prosthetist |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2022-07-21 |