| NPI | 1477715472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA B. TURNER DEGENESTE Owner 352-877-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2021-04-15 |