| NPI | 1811194368 |
|---|---|
| Doing Business As | LA FUENTE PROSTHETICS |
| Entity Type | Organization |
| Authorized Contact | BRANDON RAY LA FUENTE Manager 405-236-2882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2012-04-02 |