| NPI | 1770631376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY KAY WINGATE Owner Manager 505-268-2770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist Prosthetics Case Management (Licence: NM 01824808000) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2008-05-15 |