| NPI | 1205375706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYISHA DAKETA MILLER Cranial Prosthesis Specialist/Owner 267-453-9855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: PA CB121409) |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2023-10-13 |