| NPI | 1164775771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA DAILEY Office Manager 888-422-3044 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2012-10-19 |