| NPI | 1013059732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBER BREKKE Administrator 307-778-6595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: CO CP003160) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-02-05 |