| NPI | 1720327265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC J. WALLENTINE President 208-371-1258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |