| NPI | 1114891801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MILTON Co Owner 618-250-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-10-03 |
| Last Update Date | 2025-10-03 |