| NPI | 1295620433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY VENTRESS Manager 225-363-4224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-16 |