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NPI Code Detail

MEDICARE: ANGELLA B POLSON MF

MEDICARE: ANGELLA B POLSON MF
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224900000XMastectomy Fitter

General Provider Information

NPI Number : 1043442957
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELLA B POLSON MF
Provider Business Mailing Address
First Line : PO BOX 428
Second Line :
City : SKYLAND
State : NC
Zip : 28776-0428
Country : US
Telephone Number : 828-684-1644
Fax Number : 828-684-0648
Provider Business Practice Location Address
First Line : 3845 HENDERSONVILLE RD
Second Line :
City : FLETCHER
State : NC
Zip : 28732-8241
Country : US
Telephone Number : 828-684-1644
Fax Number : 828-684-0648
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2009
Last Update Date : 09/29/2010

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