| NPI | 1184124885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAHVE GONZALEZ Orthotist 702-478-5848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |