| NPI | 1073217550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHIA ILICIA WADE BELL Owner 510-917-2624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-03-28 |