| NPI | 1841563095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J CASTLE CEO 928-525-9263 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: AZ 2897) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: AZ 2897) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2012-04-03 |