| NPI | 1871543181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JANSEN Owner / Cp 503-626-3163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OR 11765413) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2017-09-08 |