| NPI | 1427175892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD LOUIS HERONEME Owner 918-426-4424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2009-10-20 |