| NPI | 1174377071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN SPOON Officer 602-541-0339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2024-04-16 |