| NPI | 1083746655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMITRI K. SLEEM Director 910-485-5811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 01163) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: NC 01163) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: NC 01163) | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |