| NPI | 1790307767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JYMESHA TRUITT COO Rdinator 443-978-2728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| 224P00000X Prosthetist | |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2022-01-06 |