| NPI | 1790736379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD SHANE COLTRAIN President 252-215-2215 |
| 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 | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-08-04 |