| NPI | 1407307242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS J AUGUSTIAN CEO 920-490-9046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2022-04-13 |