| NPI | 1972621365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB W SIKES C.O. 308-237-6105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-11-29 |