| NPI | 1194586115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINE JUCHTER Vice President 336-331-3480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2025-04-21 |