| NPI | 1821076308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ANTHONY NIKIEL Owner 716-712-0881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2007-09-27 |