| NPI | 1316707847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JEAN JUSTICE Office Manager 843-766-6494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225000000X Orthotic Fitter |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-03-21 |