| NPI | 1215102033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C BOWLIN Credentials Coordinator 985-974-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2011-08-09 |