| NPI | 1184431686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ANGELINE Regulatory Compliance Analyst Ii 714-961-2102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2024-12-17 |
| Last Update Date | 2024-12-23 |