| NPI | 1679025613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CARSON Treasure 520-514-7203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AZ D5396) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |