| NPI | 1790796639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY REID President/Owner 831-430-9066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 00508) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NC 00508) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: NC 00508) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2017-09-20 |