| NPI | 1710393475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL BOONE Owner 281-316-5805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 101480) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2015-04-14 |