| NPI | 1336492487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP C PHAN Owner 888-959-7088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |