Organization
MINKD OUT EXTENSIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INDIA MASON (CEO)
(301) 613-4411
Entity
Organization
Contact information
Practice address
6595 ROSWELL RD STE G-5971, ATLANTA, GA 30328-3152
(301) 613-4411
Mailing address
6595 ROSWELL RD STE G-5971, ATLANTA, GA 30328-3152
(301) 613-4411
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/27/2022
Last updated
10/23/2022
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