| NPI | 1144334715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERIE A DODGE Owner 575-208-0056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NM 03065376002) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-12-24 |