| NPI | 1760876833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVONNE D BOOKER Owner/Member 863-688-3704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: FL ce99890011) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-03-26 |