| NPI | 1093053134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANJANETTE ROBERTS Member 208-359-0547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID 004139201) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-24 |