| NPI | 1437877362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKIA AUTRY-HAYNES Managing Member 866-301-1456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2022-08-17 |
| Last Update Date | 2022-08-17 |