| NPI | 1972229797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR BURKS CEO 662-213-3617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2024-03-06 |