NPI | 1679257703 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY TAZAMEAR SMITH Owner 601-549-0710 |
Organization Subpart ? | No |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
291U00000X Clinical Medical Laboratory | |
332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
Enumeration Date | 2023-06-09 |
Last Update Date | 2024-12-09 |