Organization
FONTANA ARTIFICIAL LIMB & BRACE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY WAYNE WOOD (PRESIDENT / CERTIFIED PROSTHETIST)
(909) 822-3233
Entity
Organization
Contact information
Practice address
8576 NUEVO AVE, FONTANA, CA 92335-3826
(909) 822-3233
(909) 822-6480
Mailing address
8576 NUEVO AVE, FONTANA, CA 92335-3826
(909) 822-3233
(909) 822-6480
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000370
—
CA
Enumeration date
09/16/2006
Last updated
08/26/2008
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