Mulberry Wellness Salon LLC
Prosthetic/Orthotic Supplier in Montgomery, AL. Organization (NPI-2).
NPI number1669732301
StatusActive
Last updated in NPPESJul 31, 2013
Details
- NPI
- 1669732301
- Entity type
- Organization (NPI-2)
- Legal business name
- Mulberry Wellness Salon LLC
- Organization subpart
- No
- Enumeration date
- May 28, 2012
- Last updated
- Jul 31, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | 39089 | AL | Yes |
| 174400000X | Specialist | 161733 | AL | |
| 332BC3200X | Durable Medical Equipment & Medical Supplies, Customized Equipment | 161733 | AL | |
| 1744P3200X | Specialist, Prosthetics Case Management | 39089 | AL |
Practice location
1734 Mulberry StMontgomery, AL 36106-1524
Phone 334-819-7249 · Fax 334-819-7249
Mailing address
1734 Mulberry StMontgomery, AL 36106-1524
Phone 334-819-7249 · Fax 334-819-7249
Authorized official
Ramona J Washington
Master Cosmetologist/Owner
3348685189
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