NPI | 1104250802 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN BOE SIMMONS Owner 208-241-0876 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2013-08-29 |
Last Update Date | 2014-01-31 |