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General NPI Number Information
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NPI Number | 1326370990
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Entity Type | Organization
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Legal Business Name | THAT CERTAIN LOOK, INC.
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 300 VAN BUREN ST
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City | JUDSONIA
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State | AR
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Zip | 72081-8006
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Country | US
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Telephone | 501-729-5490
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Fax | 501-729-1511
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | JUDSONIA
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State | AR
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Zip | 72081-0297
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Country | US
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Telephone | 501-729-5490
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Fax | 501-729-1511
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Authorized Official
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Title or Position | CAO
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Name | MRS. ANITA LYNN JAMES
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Credential | CFM
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Telephone | 501-729-5490
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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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