| NPI | 1356893192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISIA LEE DERAMUS Owner / Cped 918-567-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: OK 154) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |