| NPI | 1356902449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TUCK Compliance Director 616-502-6488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Z00000X Orthotist |
| Additional Taxonomies | 224P00000X Prosthetist |
| 225000000X Orthotic Fitter | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2024-12-30 |