| NPI | 1952113888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL D GREEN Clinic Manager, CPO 838-900-3924 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 222Z00000X Orthotist |
| 224P00000X Prosthetist | |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-02-20 |