| NPI | 1639159700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BROCKMAN CEO 563-322-0971 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 060006850) |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2010-12-09 |