| NPI | 1366703399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE FARNHAM Co Owner 574-722-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 69000792A) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: IN CFm00432) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: IN CFts0099) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |