Organization
AMPUTEE AND BRACE CLNC IN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN LAMAR GUNN (PRESIDENT)
(843) 545-9999
Entity
Organization
Contact information
Practice address
605 N FRASER ST, GEORGETOWN, SC 29440-3265
(843) 545-9999
Mailing address
PO BOX 708, GEORGETOWN, SC 29442-0708
(843) 545-9999
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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