| NPI | 1275836561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE MCPHERSON Practitioner In Charge 903-316-3171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 101350) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2025-04-02 |