| NPI | 1750722120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON WILLIMAS Owner 864-205-1431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist Prosthetics Case Management (Licence: SC 90611) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |