| NPI | 1972081800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CLARKE Owner 252-881-0118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2019-10-23 |