| NPI | 1700359908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURI WALSH Manager Office/Compliance 616-840-8268 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 224L00000X Pedorthist |
| 224P00000X Prosthetist | |
| 225000000X Orthotic Fitter | |
| 222Z00000X Orthotist | |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-01-10 |