| NPI | 1205187218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN DAVID MOCK Prosthetist 619-501-5383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: CA CP003901) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |