| NPI | 1992161129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KINGDON BRADY Owner 970-484-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CO 202172) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2016-06-10 |