| NPI | 1316643133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY CHAD MANGUM Owner 435-557-6687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2025-03-10 |