| NPI | 1982603643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALAN BANKS Owner 440-816-5380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 4648210001) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2022-07-21 |