| NPI | 1740851385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ALEXANDER LEAL Owner 928-299-3130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 222Z00000X Orthotist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2023-06-22 |