| NPI | 1164844791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE VAN JENSEN President 801-528-7350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: UT 13746360-004-STC) |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2014-01-16 |