| NPI | 1497579635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUEITA DAVIS Manager 214-728-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2024-11-20 |