| NPI | 1124109590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MENDOZA BABOL Owner Doctor 509-928-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WA PO00000715) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA PO00000715) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: WA PO00000715) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2018-04-13 |