| NPI | 1619265253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD LAMAR HYDE Owner 478-474-8040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2019-08-27 |