| NPI | 1952767956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON CLARK National Payor Relations Mgr. 512-806-2879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ C001316) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2023-03-08 |