| NPI | 1457015422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASE C CHRISTOFFERSEN Owner 208-841-7020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2023-01-30 |