| NPI | 1568549848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN HALL Administrator 208-234-1960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-07-10 |