| NPI | 1669283560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE HENRY POTTINGER Chief Operations Officer 725-222-4476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 222Z00000X |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2025-11-19 |