NPI | 1528096997 |
---|---|
Doing Business As | MARY FREE BED BRACE AND CORSET SHOP |
Entity Type | Organization |
Authorized Contact | MARK A PORTH Chief Compliance Officer 616-356-1916 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Enumeration Date | 2006-06-28 |
Last Update Date | 2022-07-21 |