| NPI | 1396427654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA JACOB ALEXANDER Board Chair 984-974-9747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 222Z00000X Orthotist |
| 224P00000X Prosthetist | |
| 225000000X Orthotic Fitter | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-08-04 |