| NPI | 1932138047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY WILSON President 601-982-9060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: DE CPO02517) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2007-10-03 |