| NPI | 1891300604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRODIE RICE Owner 307-670-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 222Z00000X Orthotist |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2024-04-10 |