| NPI | 1184607335 |
|---|---|
| Doing Business As | MARY FREE BED BRACE AND CORSET SHOP |
| Entity Type | Organization |
| Authorized Contact | MARK A PORTH Chief Compliance Officer 616-840-8433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2017-03-06 |