| NPI | 1649545286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHAN MICHAEL SMITH Licensed Orthotist Prosthetist 224-653-8411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 248000569) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2016-08-02 |