| NPI | 1326781485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERLYN S DAVIS Owner 352-702-8141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-04-17 |
| Last Update Date | 2024-06-06 |