| NPI | 1235091620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATIANA WATSON Manager 770-902-5402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 224P00000X Prosthetist |
| Enumeration Date | 2025-11-24 |
| Last Update Date | 2025-11-24 |