| NPI | 1962671719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI ELIZABETH PRESCOTT Owner 612-338-4731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2023-08-28 |