| NPI | 1881771640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISKA TRUESDALE Business Manager 910-395-5775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 222Z00000X Orthotist |
| 224P00000X Prosthetist | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-04-13 |