| NPI | 1063565554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE CORYELL Owner 505-293-5215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |