| NPI | 1619296175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEJUAN LEVI SIMMONS Director Of Operations 240-418-8602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2010-05-24 |