| NPI | 1245295120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ANGELINE Reg Compliance Specialist Iii 714-961-2102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 016624327) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2021-02-09 |