| NPI | 1124482617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA R ALEXANDER General Manager 601-334-2599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2016-04-11 |