| NPI | 1407470420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELI BENTABOU Owner/Doctor 360-331-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 224L00000X Pedorthist |
| 225000000X Orthotic Fitter | |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2022-05-25 |