| NPI | 1558660498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C DAVIS Owner/Md 307-686-7346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WY 7762A) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |