| NPI | 1700378437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE MATHIE President 313-748-7534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2018-05-30 |