| NPI | 1366833097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAD LONDON MORRIS Doctor 435-674-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: UT 280014) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |