| NPI | 1790900678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE ELIOT FAULKNER Owner 405-214-1924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: OK C15550) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |