| NPI | 1912779810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY HAYES Owner 559-627-9447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2024-01-19 |