| NPI | 1154963817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURI WALSH Manager Compliance/Revenue Cycle 616-840-8268 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 222Z00000X Orthotist |
| 225000000X Orthotic Fitter | |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2019-10-15 |