| NPI | 1962022822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY ANN LA FUENTE Owner 405-740-3129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 224P00000X Prosthetist |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-09-17 |