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General NPI Number Information
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NPI Number | 1417718453
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Entity Type | Organization
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Legal Business Name | EXPERIENCE THIS FIT
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 9150 ESTATE THOMAS STE 203
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City | ST THOMAS
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State | VI
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Zip | 00802-2612
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Country | US
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Telephone | 340-201-2911
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Fax |
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Provider Business Mailing Address
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Address Line | 5302 ESTATE BORDEAUX
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City | ST THOMAS
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State | VI
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Zip | 00802-8253
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Country | US
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Telephone | 340-201-2911
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. DONNA M PHILLIP
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Credential | CFM
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Telephone | 340-201-2911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224900000X
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Taxonomy Name | Mastectomy Fitter
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License Number |
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License Number State |
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