| NPI | 1376546978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODRICK FORD STOCKWELL Office Manager 503-491-1723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2022-07-21 |