| NPI | 1912362245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHEA CLARK Owner 702-850-2898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NV nv20151659970) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2016-12-23 |