| NPI | 1912606583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN STEPHEN ELLIS Chief Executive Officer 510-537-1210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-03-02 |