| NPI | 1295879369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER LYNNETTE HENNIG Pedorthist 937-788-2402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH LPED110) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2008-08-13 |