| 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 |