| NPI | 1154777522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLITA GREEN Owner 910-920-7506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NC 88486) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |