| NPI | 1912778630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE LEE SOUTH ADAMS Owner 208-596-6834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-01-11 |