| NPI | 1194350397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE FERGUSON CEO 770-420-8110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management |
| Enumeration Date | 2020-03-08 |
| Last Update Date | 2021-08-05 |