| NPI | 1902925514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STUART L WILLETT Office Mgr 817-810-0901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 101193) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |