| NPI | 1801622568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LARSEN Presideny 801-849-8497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |