| NPI | 1881155794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROB TUCK Compliance Manager 616-502-6488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2025-11-13 |