| NPI | 1225386758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CLINTON GOODWIN Owner 928-778-4555 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AZ 3540) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |