| NPI | 1932632718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN J SPENCER Owner 406-761-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: MT DEN-DEN-LIC-1688) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |