| NPI | 1164660999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN J. BRENDEN Practice Manager/Prosthetist 308-216-0134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2015-04-13 |