| NPI | 1104896018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZY BURSON Owner/President 870-862-8841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2022-10-07 |