| NPI | 1184689085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE RAY CLAWSON President 909-621-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Z00000X |
| Additional Taxonomies | 224P00000X Prosthetist |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2024-07-19 |