| NPI | 1003126400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT L SKINNER Owner 616-698-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI CPed3413) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI CPed3429) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |