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General NPI Number Information
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NPI Number | 1194918011
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Entity Type | Organization
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Legal Business Name | WILLETT COLLECTIONS, LLC
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 09/14/2007
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Provider Practice Location Address
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Address Line | 24420 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33559-7303
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Country | US
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Telephone | 813-909-2353
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Fax | 877-617-8003
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Provider Business Mailing Address
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Address Line | 22634 ROYAL RIDGE CT
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City | LUTZ
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State | FL
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Zip | 33549-8781
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Country | US
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Telephone | 813-909-2353
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Fax | 877-617-8003
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Authorized Official
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Title or Position | SOLE MEMBER-OWNER
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Name | MRS. RONDA LYNN WILLETT
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Credential |
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Telephone | 813-523-6404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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