| NPI | 1144205766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D MCLEOD Owner/Manager 803-781-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 032383439) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: 10400 BCP) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2012-01-25 |