NPI | 1477710234 |
---|---|
Entity Type | Organization |
Authorized Contact | JEANNI CLANCY LANG Owner/Mastectomy Fitter 415-454-6058 |
Organization Subpart ? | No |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Enumeration Date | 2008-05-20 |
Last Update Date | 2008-10-01 |