| NPI | 1104163831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADISON STANGER Director 801-317-1816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: UT 7905779-0160) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2016-05-23 |