Lady Grace Stores, Inc.
NPI #1265669477 in Waltham, Massachusetts
Provider Information
- NPI Number
- 1265669477
- Entity Type
- Organization
- Organization Name
- Lady Grace Stores, Inc.
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Jun 15, 2009
- Last Updated
- Jun 15, 2009
Practice Location
- Address
- 108 RIVER ST
- City
- Waltham
- State
- Massachusetts
- ZIP Code
- 02453-8306
- Phone
- (781) 894-2081
Authorized Official
- Name
- BRUCE I GREEN
- Title
- TREASURER
- Phone
- (781) 322-1721
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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