| NPI | 1871151712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES SAMUEL CLARK Administrator 801-576-6417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |