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General NPI Number Information
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NPI Number | 1477710234
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Entity Type | Organization
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Legal Business Name | A LADYS TOUCH INC.
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 10/01/2008
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Provider Practice Location Address
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Address Line | 612 D ST
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3708
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Country | US
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Telephone | 415-454-6058
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 478
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City | FAIRFAX
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State | CA
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Zip | 94978-0478
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Country | US
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Telephone | 415-454-6058
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Fax |
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Authorized Official
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Title or Position | OWNER/MASTECTOMY FITTER
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Name | MRS. JEANNI CLANCY LANG
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Credential | ABC CERTIFIED
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Telephone | 415-454-6058
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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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