| NPI | 1912606583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L SIMMONS Regulatory Compliance Analyst Iii 859-594-2709 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2025-11-06 |