| 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 |