
| Name | Value | 
|---|---|
| PROVIDER TYPE | Other Service Providers | 
| CLASSIFICATION | Specialist | 
| DEFINITION | A case manager who provides services for patients with prosthetics.  | 
| AREA OF SPECIALIZATION | Prosthetics Case Management | 
| STATUS | Active | 
| VA CODE | V081905 | 
| X12 CODE | 1744P3200X | 
| INDIVIDUAL/NON | INDIVIDUAL | 
| MASTER ENTRY FOR VUID | YES | 
| VUID | 5253209 | 
| EFFECTIVE DATE/TIME | 
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