| NPI | 1790814853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS WILKES Authorized Official 478-224-1061 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2017-03-07 |