| NPI | 1851461123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY D. REIB Delegated Official 916-595-1314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Z00000X Orthotist |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| 225000000X Orthotic Fitter | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-02-21 |