| NPI | 1801023643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNETTE M PETERSON Secretary Treasurer 208-887-9071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2009-06-19 |