| NPI | 1104015007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POLLY A MIHALOVIC Owner 608-782-1855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2011-11-10 |