Organization
AEDIFICARE, LLC
Active
Other names
Agility Prosthetics & Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNA M LE CPO, MSOP (CLINICIAN, OWNER)
(671) 682-0140
Entity
Organization
Contact information
Practice address
347 W OBRIEN DR STE 1, HAGATNA, GU 96910-5050
(671) 682-0140
(671) 969-2726
Mailing address
PO BOX 1733, HAGATNA, GU 96932-1733
(671) 682-0140
(671) 969-2726
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/30/2021
Last updated
03/20/2023
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