| NPI | 1124399084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STEVEN MARICH Owner 401-437-8016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: RI CPO00018) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: RI CO00011) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2012-11-09 |