| NPI | 1679235303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVON CHERALE GREEN Cranial Prosthetic Specialist 870-675-1246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2023-12-26 |