| NPI | 1013474303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIAYA CHRISTINE KILPACK Business Manager 385-290-0992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2019-02-23 |
| Last Update Date | 2019-02-23 |