| NPI | 1801266549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF HENNEBERG Owner 509-928-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA 602629210) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |