| NPI | 1356340350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH GOODNER Secretary/Treasurer 501-374-5672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2025-09-11 |