| NPI | 1952155160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRAN ELIZABETH GATES President, Owner 870-307-2174 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-04-15 |