NPI | 1437187804 |
---|---|
Doing Business As | MARY FREE BED BRACE AND CORSET SHOP |
Entity Type | Organization |
Authorized Contact | MARK A PORTH Chief Compliance Officer 616-840-8433 |
Organization Subpart ? | No |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2006-06-28 |
Last Update Date | 2022-07-21 |