| NPI | 1396017570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE THOMAS Office Manager 307-637-7663 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2019-03-05 |