| NPI | 1144244633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LASHEA WHITE President 662-841-2476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MS 041163411) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2022-10-05 |