| NPI | 1124282108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE MOWRY CEO 760-795-5440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: GA 000047) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2025-03-06 |