| NPI | 1952154833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRAN ELIZABETH GATES Owner, President 870-307-2174 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-05-14 |