| NPI | 1417117383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE F BUCK Owner 870-356-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: AR AR20114) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2008-06-13 |