| NPI | 1992019616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ERVINE FATKIN Owner 702-435-7987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-12-27 |