| NPI | 1679156699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCINDA B BUSCH Sr. Administrative Specialist 765-756-5014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2023-12-19 |