| NPI | 1457656878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE KELLY DYER Secretary 435-757-0254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-01-15 |
| Last Update Date | 2012-12-03 |