| NPI | 1235361585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC E WERNER Owner/CPO 631-482-1650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 222Z00000X |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2021-12-02 |