| NPI | 1073879599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSSLAND RESHELL DAWN-DARNELL Owner/ Operator 469-685-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |