| NPI | 1205027844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN BRET LEE President 601-664-7004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MS 061187399) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2020-03-11 |