| NPI | 1396061644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMRY JOHNSRUD Interim COO 920-748-9190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2011-04-05 |