| NPI | 1457713745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON BIGELOW President 801-634-2143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: UT 1427819922) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 1427819922) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-03-24 |