| NPI | 1104417831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL STUTZENBURG Vice President 610-730-1158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2021-01-26 |