| NPI | 1427563600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELORES FRY Billing Specialist 817-361-4342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: DC COM2738) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: DC COM2738) |
| Enumeration Date | 2017-12-09 |
| Last Update Date | 2018-03-14 |