| NPI | 1841748415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENECIA LASALLE JEAN Cranial Prosthesis Specilaist 786-617-2606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |