| NPI | 1104670744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MISEVCH Credentialing 520-322-6274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |