NPI | 1962133470 |
---|---|
Entity Type | Organization |
Authorized Contact | TATIANA RECHELLE NELSON Prosthetic Orthotic Provider 702-752-8354 |
Organization Subpart ? | No |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Enumeration Date | 2022-06-23 |
Last Update Date | 2022-06-23 |