| NPI | 1245724822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHARLES President 801-255-5202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: AZ 21067439) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-09-14 |