| NPI | 1174357651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED LUECKE COO 330-492-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2026-05-22 |