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General NPI Number Information
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NPI Number | 1588926968
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Entity Type | Organization
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Legal Business Name | MUSE INTIMATES LLC
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Dates
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Enumeration Date | 06/12/2012
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Last Update Date | 06/12/2012
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Provider Practice Location Address
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Address Line | 1876 UTICA SQ SUITE 2C
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City | TULSA
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State | OK
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Zip | 74114-1424
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Country | US
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Telephone | 918-392-3430
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Fax | 918-392-3431
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Provider Business Mailing Address
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Address Line | 1876 UTICA SQ SUITE 2C
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City | TULSA
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State | OK
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Zip | 74114-1424
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Country | US
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Telephone | 918-392-3430
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Fax | 918-392-3431
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | DEBORAH CROISANT
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Credential | CFM
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Telephone | 918-392-3430
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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 | OK
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