| NPI | 1710528211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ERIC PETERSON Owner 208-971-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-10-05 |
| Last Update Date | 2024-10-25 |