NPI | 1588179212 |
---|---|
Entity Type | Organization |
Authorized Contact | GRACE ANGELINE Reg Compliance Specialist Iii 714-961-2102 |
Organization Subpart ? | Yes |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2017-12-04 |
Last Update Date | 2022-01-10 |