| NPI | 1700676400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJ YERGENSEN Admin 435-986-9369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2025-05-07 |
| Last Update Date | 2025-07-09 |