| NPI | 1093277485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN LAFAYETTE NEWSOME Vice Presidnet 760-599-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2022-01-06 |