| NPI | 1104459072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN ADAM DECKER Director Of Operations 480-417-1860 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-04-13 |