| NPI | 1245698984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENITA LEICHELLE KIMBALL Owner 916-480-9501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: CA C52184) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2025-04-04 |