| NPI | 1275747628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA C GRIGGS Director, Manager 307-734-2877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: WY OT059) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WY OT059) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2012-10-23 |