| NPI | 1356083844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL JOHNSON Owner 310-428-8309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-04-13 |