| NPI | 1316395718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY BARDIN MOORE President 719-633-4028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: CO 106234) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |