| NPI | 1124022959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E PRATER Office Manager 619-285-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0900X Clinic/Center, Amputee |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2009-11-18 |