| NPI | 1669459749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE ANN INMAN Practice Manager 602-222-3032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2021-08-06 |