| NPI | 1265157994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY CARROLL Owner 801-698-8850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Additional Taxonomies | 224P00000X Prosthetist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2022-10-05 |