| NPI | 1770618993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERI LYNNE GORDON Owner 801-489-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: UT Y47646) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |