| NPI | 1508608167 |
|---|---|
| Other Name | MARY FREE BED BRACE AND CORSET SHOP |
| Entity Type | Organization |
| Authorized Contact | ROBERT TUCK Compliance Director 616-502-6488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-12-30 |