| NPI | 1346614179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DEAN Owner 406-868-3861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |