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General NPI Number Information
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NPI Number | 1689850513
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Entity Type | Organization
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Legal Business Name | COMFORT WIGS ETC CO
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 2410 S STEMMONS FWY SUITE C
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City | LEWISVILLE
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State | TX
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Zip | 75067-8777
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Country | US
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Telephone | 214-488-8885
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Fax | 972-316-8885
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Provider Business Mailing Address
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Address Line | 2410 S STEMMONS FWY SUITE C
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City | LEWISVILLE
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State | TX
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Zip | 75067-8777
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Country | US
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Telephone | 214-488-8885
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Fax | 972-316-8885
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Authorized Official
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Title or Position | PRESIDENT/MANAGER
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Name | MR. DONALD R. SEAL
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Credential |
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Telephone | 214-488-8885
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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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