| NPI | 1164711420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH CHRISTOPHER LAKE Chief Clinical Director 817-358-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 80) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2011-08-31 |