| NPI | 1912011602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA JO HANSON Owner 432-366-1158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-06-13 |