| NPI | 1154063345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RACHELLE JOHNSON CEO 267-408-7984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist Prosthetics Case Management |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-04-25 |