| NPI | 1730747189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN KIRK WILSON CEO 775-750-7429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2021-01-14 |