NPI | 1154322261 |
---|---|
Entity Type | Organization |
Authorized Contact | TRINA BRICKEY Store Manager 501-227-5537 |
Organization Subpart ? | No |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: AR 02063560001) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2020-08-22 |