| NPI | 1073511812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KEITH WADE Vice President 228-875-3828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2020-08-17 |