| NPI | 1134609357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L WILSON Owner 719-846-7387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CO 7109) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |