| NPI | 1952507378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA D DAVIS Mastectomy Fit Organizer 770-429-7004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2022-07-21 |