| NPI | 1053551432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON TANNER Owner 316-630-8420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2023-02-14 |