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General NPI Number Information
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NPI Number | 1811188105
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Entity Type | Organization
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Legal Business Name | DELIA FOX D.B.A. DELIAS WIGS & COIFFURES, INC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 03/26/2009
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Provider Practice Location Address
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Address Line | 47 PANTOOSET RD
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City | HANOVER
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State | MA
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Zip | 02339
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Country | US
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Telephone | 781-826-3881
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Fax | 508-747-5935
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Provider Business Mailing Address
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Address Line | 47 PANTOOSET RD. @ COUNTRY VILLA H.S.
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City | HANOVER
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State | MA
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Zip | 02339
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Country | US
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Telephone | 781-826-3881
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Fax | 508-747-5935
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DELIA EDEN FOX
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Credential | LHD
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Telephone | 781-826-3881
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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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