| NPI | 1831364702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI TIMMRECK Owner 352-208-0467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2017-03-23 |