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General NPI Number Information
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NPI Number | 1669676805
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Entity Type | Organization
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Legal Business Name | A WOMANS PLACE INC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 2614 W JEFFERSON ST
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City | JOLIET
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State | IL
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Zip | 60435-6433
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Country | US
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Telephone | 815-744-9052
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Fax | 815-744-9389
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Provider Business Mailing Address
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Address Line | 2614 W JEFFERSON ST
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City | JOLIET
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State | IL
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Zip | 60435-6433
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Country | US
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Telephone | 815-744-9052
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Fax | 815-744-9389
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MRS. BELINDA J DUST
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Credential |
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Telephone | 815-744-9052
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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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