| NPI | 1871023515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EDWARD PRATER Office Manager 619-285-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QA0900X Clinic/Center, Amputee | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2024-03-25 |