| NPI | 1275140022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MOORE Certified Prosthetist Orthotist 719-231-7893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-09-25 |