| NPI | 1881657260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERWIN MOORE Owner 870-424-4710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2003027560) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2008-08-26 |