| NPI | 1114176138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH J WILSON Owner/V.P. 314-535-5359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MO 17156319) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2008-09-15 |