| NPI | 1205296365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEVONNE FUNCHES Director 702-754-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NV NV20161129474) |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2016-03-02 |