| NPI | 1629399852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON MAXON MALDONADO Manager 602-265-0077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2012-10-12 |