Healthcare Provider Details

I. General information

NPI: 1396746954
Provider Name (Legal Business Name): LADIES FIRST CHOICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 GREAR ST NE
SALEM OR
97301-2747
US

IV. Provider business mailing address

2375 GREAR ST NE
SALEM OR
97301-2747
US

V. Phone/Fax

Practice location:
  • Phone: 503-363-3940
  • Fax: 503-363-1425
Mailing address:
  • Phone: 503-363-3940
  • Fax: 503-363-1425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MS. JOANIE POWELL
Title or Position: CO-OWNER
Credential:
Phone: 503-363-3940