| NPI | 1265487854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD EDWARD LUNDEEN Owner 801-255-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: UT F34288) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-08-22 |