| NPI | 1851980007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY MARIE WASTSON Owner 513-478-4169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-15 |