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General NPI Number Information
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NPI Number | 1417064486
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Entity Type | Organization
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Legal Business Name | WOMENS IMAGE CENTER
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 80 ERDMAN WAY SUITE 204
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City | LEOMINSTER
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State | MA
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Zip | 01453-1840
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Country | US
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Telephone | 978-534-0200
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Fax | 978-534-0285
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Provider Business Mailing Address
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Address Line | 80 ERDMAN WAY SUITE 204
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City | LEOMINSTER
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State | MA
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Zip | 01453-1840
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Country | US
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Telephone | 978-534-0200
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Fax | 978-534-0285
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY ANN AFRAME
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Credential | CFM
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Telephone | 978-660-9726
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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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