| NPI | 1629061007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLAF MICKLE HOLM Owner/President 813-224-0525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL POR124) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2019-12-18 |