| NPI | 1629446091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MILLER Owner 304-699-2373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: OH LPO074) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2019-11-25 |