NPI | 1730235417 |
---|---|
Entity Type | Organization |
Authorized Contact | CHUCK MCMILLAN Owner 985-674-4170 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: LA Z10781) |
Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
Enumeration Date | 2007-01-26 |
Last Update Date | 2012-04-23 |