| NPI | 1285908624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ANGELINE Reg Compliance Specialist Iii 714-961-2102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2020-04-10 |