| NPI | 1548229255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L SIMMONS Regulatory Compliance Analyst Iii 859-594-2709 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: WA 602056141) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2025-10-23 |