| NPI | 1083005375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DELEON Compliance Coordinator 317-436-6178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2025-06-20 |