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General NPI Number Information
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NPI Number | 1417130709
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Entity Type | Organization
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Legal Business Name | ARCTIC WRAP NORTH
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Dates
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Enumeration Date | 12/10/2007
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 12760 BESSEMER ST
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-4411
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Country | US
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Telephone | 818-761-0761
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Fax |
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Provider Business Mailing Address
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Address Line | 12439 MAGNOLIA BLVD #133
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91607-2450
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Country | US
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Telephone | 818-761-0761
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. KARIN S CLARKE
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Credential |
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Telephone | 818-761-0761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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