| NPI | 1821464322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA C ALLEN Owner 234-521-9147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist Prosthetics Case Management (Licence: OH COSM.933895) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |