| NPI | 1710498696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLASCIET HARPER OWENS Owner/Practitioner 601-910-8325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2019-12-19 |