| NPI | 1275311417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENEEN FRENCH WILSON Owner 540-449-5753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-09-19 |