| NPI | 1073623237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY R BRADSHAW Owner 970-482-7116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WY 2008758) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WY 2008758) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: WY 2008758) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |