| NPI | 1851756050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAD NEILSON Owner 801-392-0075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2016-05-31 |