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General NPI Number Information
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NPI Number | 1821636754
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Entity Type | Organization
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Legal Business Name | RBS WIG STUDIO BOUTIQUE & SPA LLC
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 4401 E COLONIAL DR STE 105B
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City | ORLANDO
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State | FL
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Zip | 32803-5200
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Country | US
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Telephone | 321-282-1479
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Fax | 833-276-2220
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Provider Business Mailing Address
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Address Line | 12472 LAKE UNDERHILL RD STE 163
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City | ORLANDO
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State | FL
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Zip | 32828-7144
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Country | US
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Telephone | 321-282-1479
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHANTAN AKPAN
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Credential |
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Telephone | 321-282-1479
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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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