{
"Npi": {
"NPI": "1891873006",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIMB CRAFT, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "810 E CHAPMAN AVE",
"SecondLineMailingAddress": "SUITE C",
"MailingAddressCityName": "FULLERTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92831-3850",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-626-0417",
"MailingAddressFaxNumber": "714-626-0319",
"FirstLinePracticeLocationAddress": "810 E CHAPMAN AVE",
"SecondLinePracticeLocationAddress": "SUITE C",
"PracticeLocationAddressCityName": "FULLERTON",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92831-3850",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-626-0417",
"PracticeLocationAddressFaxNumber": "714-626-0319",
"EnumerationDate": "11/02/2006",
"LastUpdateDate": "08/01/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEE",
"AuthorizedOfficialFirstName": "NATHAN",
"AuthorizedOfficialMiddleName": "RYAN",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CPO",
"AuthorizedOfficialTelephoneNumber": "714-626-0417",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "CPO02709",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}