| NPI | 1679568604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE A MEJORADA Certified & Licensed Prosthetist 708-456-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 211000146) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2008-07-02 |