Modish Beaute LLC
NPI #1154020865 in Locust Grove, Georgia
Provider Information
- NPI Number
- 1154020865
- Entity Type
- Organization
- Organization Name
- Modish Beaute LLC
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Mar 1, 2023
- Last Updated
- Mar 1, 2023
Practice Location
- Address
- 532 MOLINE WAY
- City
- Locust Grove
- State
- Georgia
- ZIP Code
- 30248-4471
- Phone
- (321) 863-2589
Authorized Official
- Name
- OCTAVIA LYONS
- Title
- MANAGER
- Phone
- (321) 863-2589
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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