| NPI | 1750951059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG PORTER Manager 907-290-9176 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 171WV0202X Contractor, Vehicle Modifications |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-06-29 |