| NPI | 1154371375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID PARK President 361-888-5347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 101103) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-22 |