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 |