| NPI | 1619143385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLYSON DAUGHERTY Onwer/PT 252-215-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |