| NPI | 1780247452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHNAIE ANNE KINGSTON Administrator, Registered Agent 407-245-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2021-01-18 |