| NPI | 1659628451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY LYNN JORDAN Owner/Orthotist/Prosthetist 806-353-7276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 488) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 488) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2012-08-10 |