| NPI | 1972556629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL BLOM Owner 972-599-9594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 549650000) |
| 225100000X Physical Therapist (Licence: TX 655650000) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |