| NPI | 1255082962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOREEN L CLARK Cranial Prosthesis Specialist 936-206-8796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2022-01-13 |