| NPI | 1689451932 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | PORSCHE' QUINCOLA THOMAS Cranial Prosthesis Specialist 734-686-7523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-11 |