| NPI | 1851440911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN DOMINIC CRESAP President 509-663-2490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: WA PS00000162) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: WA OI00000163) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2009-08-27 |