NPI | 1861872269 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL SCOTT JOHNSON Owner 208-733-0505 |
Organization Subpart ? | No |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: ID DME236) |
Enumeration Date | 2015-06-02 |
Last Update Date | 2021-01-07 |