Healthcare Provider Details

I. General information

NPI: 1831976554
Provider Name (Legal Business Name): FULL FIGURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3437 MASONIC DR STE 1126
ALEXANDRIA LA
71301-3641
US

IV. Provider business mailing address

PO BOX 372
MONTGOMERY LA
71454-0372
US

V. Phone/Fax

Practice location:
  • Phone: 318-625-7457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State

VIII. Authorized Official

Name: MRS. TARA SAPP
Title or Position: OWNER
Credential:
Phone: 318-332-3657