| NPI | 1073519831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE M WOOLEY Owner/President 863-682-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL PRO36,PRO60,ORT91,OR) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2020-08-22 |