| NPI | 1215105481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE V VIDETICH Podiatrist 402-477-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NE NE134) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-06-06 |