| NPI | 1255339396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A WATSON President/Director 615-327-2882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Z00000X |
| Additional Taxonomies | 224P00000X Prosthetist |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2022-07-21 |