| NPI | 1053811174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON RICHARD TAPIO Orthotist/Owner 906-376-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI 5306004871) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: bocs60682) |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-06-16 |