| NPI | 1679628465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN REAMS Owner 618-939-7577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2023-01-18 |