| NPI | 1760225148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANDRE SHONDALE MOSTELLA Owner 225-316-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 224P00000X Prosthetist |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2025-02-25 |