| NPI | 1871908194 |
|---|---|
| Former Legal Business Name | SPORTS AND WELLNESS, LLC |
| Entity Type | Organization |
| Authorized Contact | JOHN E SHERO President/CEO 817-894-9436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-04-07 |