| NPI | 1275134199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF SCOTT BROUWER Owner 602-249-0999 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2021-02-03 |