| NPI | 1154894046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN PAUL TAYLOR Owner 616-490-8564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2019-07-15 |