| NPI | 1982884029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY DERRICK SCOGGINS President 601-906-9396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MS APPLIED FOR) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-06 |