| NPI | 1265813968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL A JACKSON Co 843-871-0600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: SC 010116126) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2016-08-31 |