| NPI | 1104012319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILGIA PRUMBS Member 423-246-7272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN PRO16) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2008-01-07 |