| NPI | 1396066015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN ERIN MALONE-GRIEGO Manager 505-344-3465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: NM ZRBL#20100402) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2011-12-26 |