Healthcare Provider Details
I. General information
NPI: 1881263093
Provider Name (Legal Business Name): KUTE&KATCHY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2021
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2104 RIDGE ST
SOUTH BOSTON VA
24592-2032
US
IV. Provider business mailing address
PO BOX 1353
SOUTH BOSTON VA
24592-1353
US
V. Phone/Fax
- Phone: 434-272-9952
- Fax:
- Phone: 434-272-9952
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRITTANY
MCWHITE
Title or Position: CRANIAL PROSTHESIS SPECIALIST
Credential:
Phone: 434-272-9952