| NPI | 1780882605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY BROADBENT Owner 801-590-2703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: UT 6142158-1714) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2016-07-01 |