| NPI | 1023355450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL PERALES Principle 702-808-2998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2013-01-04 |