| NPI | 1467448779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORI DANIEL SHAVER Owner 208-232-9392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID 1319LS) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2008-02-11 |