| NPI | 1790091890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI LAWRENCE Manager 270-904-6130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN 0078654) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2021-07-29 |