| NPI | 1649290107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SHANE EVANS Business Owner/Manager 209-932-0170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: CA 07-00072230) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-09-15 |