| NPI | 1366137812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORNE T MACDONALD Owner 719-344-9497 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-10 |