| NPI | 1265901110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIJAH WALKER President 904-504-0601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225000000X Orthotic Fitter |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2021-01-12 |