| NPI | 1629084942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN STEPHEN ELLIS Chief Operations Officer 209-612-6168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-11-12 |