| NPI | 1023382116 |
|---|---|
| Doing Business As | VISAGE CUSTOM PROSTHETICS |
| Entity Type | Organization |
| Authorized Contact | AMANDA BEHR Anaplastologist 314-732-2658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 229N00000X Anaplastologist |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |