| NPI | 1053856625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDRIC HUYKE Member/Manager 928-278-7627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2019-05-02 |