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General NPI Number Information
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NPI Number | 1508191339
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Entity Type | Organization
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Legal Business Name | PERSONAL TOUCH FITTING
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 851 DUNLAWTON AVE SUITE 201
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City | PORT ORANGE
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State | FL
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Zip | 32127-4233
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Country | US
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Telephone | 386-761-8711
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Fax |
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Provider Business Mailing Address
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Address Line | 3131 VICTORY PALM DR
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City | EDGEWATER
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State | FL
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Zip | 32141-6129
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Country | US
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Telephone | 386-882-1161
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KRISTEN ANN HANAK
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Credential | P.T.
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Telephone | 386-882-1161
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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 | PT11571
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License Number State | FL
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