| NPI | 1982011102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NACER KHENOUCHE Certified Prosthetist And Orthotist 708-529-0753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 211.000279) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |