| NPI | 1023222601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN PEDRICK Administrator 307-742-3120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WY 5003556) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |