| NPI | 1649485269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY MIKKEL BRATRUD Physical Therapist 480-396-9020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |