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General NPI Number Information
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NPI Number | 1538669056
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Entity Type | Organization
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Legal Business Name | EBB & FLOW LACTATION SERVICES
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 10/05/2019
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Provider Practice Location Address
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Address Line | 217 COLUMBUS RD STE 105
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City | ATHENS
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State | OH
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Zip | 45701-1393
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Country | US
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Telephone | 740-818-8871
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Fax | 844-442-5114
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Provider Business Mailing Address
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Address Line | PO BOX 393
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City | ATHENS
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State | OH
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Zip | 45701-0393
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Country | US
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Telephone | 740-818-8871
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Fax | 844-442-5114
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Authorized Official
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Title or Position | LACTATION CONSULTANT/OWNER
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Name | JULIE ALAYNE GLADNEY
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Credential | BS, LPN, IBCLC
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Telephone | 740-818-8871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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