| NPI | 1972610897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY PARTAIN Member 256-549-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: AL 41) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: AL 42) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |