| NPI | 1790747244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA R MULLIS Manager 704-749-6291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2022-08-11 |