| NPI | 1326058058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA L CROUSE Owner/Admin 757-850-2835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: VA C12887) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2024-05-09 |