| NPI | 1750943114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT ROSS MILLER Manager 630-880-9528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2019-07-05 |