| NPI | 1477606713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LOUISE HOLLY Owner 602-264-1201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: 332B00000X) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: 332bc3200x) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: 335e00000x) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |