| NPI | 1790712073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT JAMES BROWN Director Of Operation 503-231-1529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2012-06-28 |