| NPI | 1811145071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAE MI MADDEN Owner 256-237-1107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: AL 2403) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2008-08-29 |