| NPI | 1689706053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SCOTT JOHNSON Owner/CPO 208-733-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2021-01-07 |