| NPI | 1518763986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREANNA HERBERT Onwer 661-220-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2026-05-29 |