| NPI | 1932652567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD GOERTZEN President 309-676-2276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 211000147) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2018-07-30 |