| NPI | 1932196847 |
|---|---|
| Doing Business As | SHOP ON MAIN |
| Entity Type | Organization |
| Authorized Contact | SHIRLEY JOYCE MORETTI President 714-569-0318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: CA C20007) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2010-08-02 |