| NPI | 1801532957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE RANDELL MITCHELL Owner/Operator 501-732-6041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |