| NPI | 1710983838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JACKSON-MCMAHON President 307-637-7663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WY 02-0-05230) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2020-08-22 |