| NPI | 1851898415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHIPP President/Owner 208-938-9912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: ID D4172) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |