| NPI | 1487653044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA LYNNE ALDRIDGE Manager 270-469-1391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2013-02-15 |