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General NPI Number Information
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NPI Number | 1558049205
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Entity Type | Organization
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Legal Business Name | ADMYRHER EXTENTIONS
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 27970 CHAGRIN BLVD STE W222
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City | WOODMERE
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State | OH
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Zip | 44122-4461
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Country | US
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Telephone | 216-952-9083
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Fax |
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Provider Business Mailing Address
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Address Line | 5667 TURNEY RD
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City | CLEVELAND
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State | OH
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Zip | 44125-3972
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Country | US
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Telephone | 216-952-9083
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS TAMELA WATTERS
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Credential |
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Telephone | 216-952-9083
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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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