| NPI | 1851006944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEHERDA ROCHELLE BROWN Organizer/ Member 803-464-4606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-25 |