| NPI | 1730628389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LOUIS KALDY Member 702-232-4610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NV E0060422017-5) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NV E0060422017-5) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2017-02-15 |