Organization
DIANNA L POWELL
Active
Other names
Barstow Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANNA LYNNE POWELL (OWNER)
(760) 256-5225
Entity
Organization
Contact information
Practice address
544 E WILLIAMS ST, BARSTOW, CA 92311-2941
(760) 256-5225
(760) 255-4647
Mailing address
544 E WILLIAMS ST, BARSTOW, CA 92311-2941
(760) 256-5225
(760) 255-4647
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXB000070
—
CA
Enumeration date
06/14/2006
Last updated
06/13/2008
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