| NPI | 1073841078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A SIMONSON President 321-638-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |