| NPI | 1316236995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE A BENNETT Owner/Manager 928-772-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AZ 20636829-L) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-04 |