| NPI | 1376226910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA F MICKELSON Manager Of Revenue Cycle Management 309-285-7752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2023-08-10 |