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 |