| NPI | 1104091693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA V. WHITE President 702-870-0853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: NV S20592) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2010-10-18 |