| NPI | 1750568762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FONDA BRICE Co Owner/Office Manager 423-921-8087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2009-01-07 |