| NPI | 1811306210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR LEWIS Owner 313-408-9599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI CO0004213) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |