| NPI | 1225628670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIODUN OLUWAGBENGA SOBOWALE Prosthetist/Orthotist 215-298-0604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 222Z00000X Orthotist |
| 224P00000X Prosthetist | |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2022-01-20 |