| NPI | 1154621720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PRATER Office Manager 619-285-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0900X Clinic/Center Amputee |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2011-03-04 |