| NPI | 1841641883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PORSCHE EALY Owner 910-890-7471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 1744P3200X Specialist Prosthetics Case Management |
| 224P00000X Prosthetist | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2024-01-03 |