| NPI | 1780913046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CARLOS FELICIANO Owner 910-371-3196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2009-12-16 |