NPI | 1730682832 |
---|---|
Entity Type | Organization |
Authorized Contact | OUMOU K BAH Compliance & Medicaid Specialist 602-393-8188 |
Organization Subpart ? | Yes |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Enumeration Date | 2018-03-14 |
Last Update Date | 2025-09-23 |