| NPI | 1669935292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WILLIAM LISTON Certified Prosthetist 385-425-3960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-04-10 |