| NPI | 1376883660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GREGORY WELLS COO 909-908-3920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 71509) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2015-09-23 |