| NPI | 1902085442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN MALONE Owner 502-899-9177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: KY CFO00523) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2013-05-08 |