| NPI | 1760159933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER DIANE FRAISER Owner 907-302-7367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2022-05-03 |