| NPI | 1104672682 |
|---|---|
| Doing Business As | PRIMARYTHERAPYSOURCE LLC |
| Entity Type | Organization |
| Authorized Contact | DEBORAH JAN YINGST Managing Member 208-734-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-04-25 |