| NPI | 1164419743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A BOLAND Owner, Orthotist/Prosthetist 478-953-2922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: GA No state licensure) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2021-11-11 |