| NPI | 1932894292 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | MARTHA J OWENS Member 757-301-1235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-04-11 |