| NPI | 1700433067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY R CARELOCK Owner 352-569-1288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 224P00000X Prosthetist |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2022-12-30 |