| NPI | 1952580763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY AUTRY Owner 480-236-9759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: AZ CO004432) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2011-11-09 |