| NPI | 1255655585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAINE ALAN FORD President 435-867-8986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: UT 3346421202) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2010-03-15 |