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General NPI Number Information
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NPI Number | 1376894188
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Entity Type | Organization
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Legal Business Name | SHAPEEZ, LLC
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 205 PERRY PKWY STE 1
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2141
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Country | US
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Telephone | 877-360-8426
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Fax |
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Provider Business Mailing Address
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Address Line | 205 PERRY PKWY STE 1
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2141
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Country | US
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Telephone | 877-360-8426
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. DAVID BERNER
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Credential |
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Telephone | 240-893-0101
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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 | MD
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