| NPI | 1780345173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA R NICHOLS Cranial Prothesis Specialist 901-896-6685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-01-06 |