| NPI | 1639691884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI WAGNER Certified Pedorthist 913-369-8734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2022-07-21 |