| NPI | 1124096292 |
|---|---|
| Former Legal Business Name | COASTAL CAROLINA PROSTHETICS & ORTHOTICS, INC |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY S WILLIAMSON Owner 252-338-3002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-12-09 |