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General NPI Number Information
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NPI Number | 1902264781
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Entity Type | Organization
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Legal Business Name | GARDE BIEN SPASALON
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 12752 KINGSTON PIKE SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37934-0946
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Country | US
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Telephone | 865-671-1996
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Fax |
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Provider Business Mailing Address
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Address Line | 12752 KINGSTON PIKE SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37934-0946
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Country | US
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Telephone | 865-671-1996
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | STACEY M HANDEL
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Credential |
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Telephone | 865-671-1996
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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 | 00024970
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License Number State | TN
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