| NPI | 1972555043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA HUBBARD Member/Manager 314-872-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |