| NPI | 1881065043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC C ELLINGSEN Owner 509-924-2866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: WA 601992748) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |