| NPI | 1487089397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE CLINT GOSS Owner 254-771-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 101255) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |