| NPI | 1962780932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EARL FELLING President 612-851-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2014-12-09 |