NPI | 1104950260 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN EDWARD PRATER Office Manager 619-285-5040 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QA0900X Clinic/Center, Amputee |
Enumeration Date | 2007-03-14 |
Last Update Date | 2020-08-22 |