| NPI | 1528163128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY BRADSHAW AVERITT Owner 254-776-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 101170) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2025-08-20 |