| NPI | 1114210218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMONA HERTZELL Mbr 336-274-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NC 600815424) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2022-08-02 |