| NPI | 1184766438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM G SELF Owner 303-426-8812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CO 20828) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2022-07-21 |