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General NPI Number Information
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NPI Number | 1508343328
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Entity Type | Organization
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Legal Business Name | NAPPY ROOTZ 15, LLC
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 393 CORNER SQUARE PLAZA
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City | MONCKS CORNER
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State | SC
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Zip | 29461
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Country | US
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Telephone | 843-714-7514
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Fax |
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Provider Business Mailing Address
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Address Line | 393 CORNER SQUARE PLZ
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City | MONCKS CORNER
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State | SC
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Zip | 29461-3211
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Country | US
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Telephone | 843-714-7514
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Fax |
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Authorized Official
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Title or Position | 0WNER
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Name | MARTINA ALIN SNIDER
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Credential |
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Telephone | 843-714-7514
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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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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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