| NPI | 1790061034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL PRICE Director Of Reimbursement 503-493-8288 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: GA OCC002226) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2014-02-19 |