| NPI | 1417369364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN JENKINS CEO 903-571-5631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2024-02-12 |