| NPI | 1780135269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ROBERTS WIGGEN Manager 828-595-9371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |