| NPI | 1275074684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDUL REHMAN Administrator 307-222-0371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-04-12 |