| NPI | 1871765883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WESLEY ANDERSON Owner/Certified Prosthetist Orthoti 731-286-6006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN PRO0000000087) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN ORT0000000109) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2017-06-01 |