| NPI | 1508863689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R. MOORE Ownder 337-232-7647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: LA CO003825) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2020-08-22 |