| NPI | 1053640326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY REBARCAK Manager 307-632-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2009-12-16 |