| NPI | 1427659408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD DALE MILLER Owner 208-377-3850 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |