| NPI | 1831578913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L MANOUSE Member 860-355-2443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: CT CPO2372) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-05-22 |