| NPI | 1205802899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE IRENE HEROD Owner 928-541-1825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AZ 20002621) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2015-05-21 |