Organization
IMAGE PROSTHETICS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD WAYNE KLUGE JR. BCO (CEO)
(909) 478-9081
Entity
Organization
Contact information
Practice address
11306 MOUNTAIN VIEW AVE, SUITE B, LOMA LINDA, CA 92354-3832
(909) 478-9081
(909) 478-9084
Mailing address
11306 MOUNTAIN VIEW AVE, SUITE B, LOMA LINDA, CA 92354-3832
(909) 478-9081
(909) 478-9084
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/02/2013
Last updated
08/03/2015
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