Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ocularist |
156FX1700X | |||
Anaplastologist |
229N00000X |
| NPI # | 1972002632 |
| LBN Legal business name | PROSTHETICS ADVANCEMENT LAB, LLC |
| Authorized official | JANET CHAO - (MANAGING MEMBER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/08/2018 |
| Last updated | 07/02/2020 - About 6 years ago |
| Identifiers | n/a |
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