| NPI | 1285695783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH MARVIN HEIDE President 218-486-1963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2007-10-30 |