| NPI | 1104823715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA A KNUTSON President 623-434-5585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 07-579814-D) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AZ 07-579814-D) |
| Enumeration Date | 2005-06-29 |
| Last Update Date | 2009-06-08 |