| NPI | 1508521501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELEEAH HARRIS Member/Organizer 716-319-4842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2021-11-04 |