| NPI | 1750576955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL TORI SHAVER Owner 208-235-7243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2007-09-11 |