| NPI | 1326319633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY D DAVIDSON Member 931-854-9455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN PRO-7) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN ORT-6) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |