| NPI | 1275380842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIANE PUGH Owner 330-625-5911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Additional Taxonomies | 171400000X |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2024-05-02 |
| Last Update Date | 2024-05-02 |