| NPI | 1962435875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY J BRADSHAW Owner 970-482-7116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: CO 03404280000) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CO 03404280000) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CO 0340428000) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-11-28 |