| NPI | 1588930077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD HAAK Owner 480-600-8859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AZ 6823) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |