| NPI | 1316790348 |
|---|---|
| Doing Business As | CCC21 |
| Entity Type | Organization |
| Authorized Contact | CHEYENNE LEWIS Manager 323-202-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-04-09 |