NPI | 1518656925 |
---|---|
Entity Type | Organization |
Authorized Contact | NARQUITA BRIDGES Provider/Owner 228-314-3554 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 174400000X Specialist |
335E00000X Prosthetic/Orthotic Supplier | |
Enumeration Date | 2023-05-02 |
Last Update Date | 2023-11-30 |