NPI | 1982292678 |
---|---|
Entity Type | Organization |
Authorized Contact | GRACE ANGELINE Reg Compliance Specialist Iv 714-961-2102 |
Organization Subpart ? | Yes |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2021-01-07 |
Last Update Date | 2022-05-01 |