| NPI | 1437316684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI JEAN JOHNSTON President 815-639-9251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225000000X Orthotic Fitter (Licence: IL 011.167276) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-08-25 |