| NPI | 1225352172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY A HICKOK Owner 715-669-5520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: WI 4639-024) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-03-22 |