| NPI | 1083899041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL ELLIS Chief Manager/Practitioner 320-762-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2013-04-26 |