| NPI | 1154643195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HARTSHORN President/Owner 774-306-1536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL orf153) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL orf153) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2023-02-09 |