| NPI | 1992792352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURICE A JOHNSON Owner/President 843-824-0625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2022-06-06 |