| NPI | 1407286297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BACILIO V MORENO Licensed Prosthetist 210-593-0953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 428) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |