| NPI | 1649322512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD GOERTZEN President 309-676-2276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 060008643213000063) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2018-07-30 |