| NPI | 1831581164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY LEE PENFOLD President 906-231-2212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: DE CPO01440) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2019-03-18 |