| NPI | 1376866954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY A HICKOK Owner 715-925-2471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: WI 4639-024) |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2010-03-10 |