| NPI | 1669885836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS SANTRELL BANKS Prosthetist/Owner 601-856-8360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MS C26406) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-12 |