| NPI | 1508179847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMSHAD AHMED Manager 304-521-4988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: VA CPO02136) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MD C15500) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2023-11-27 |