NPI 1023543048

5th Avenue Grooming Lounge

Organisation Prosthetic/Orthotic Supplier Arlington, TX

Practice location

Address: 1201 N Watson Rd. Suite 283, Arlington, TX 76116
Phone: (817) 899-3054
Mailing address: 1201 N Watson Rd STE 283, Arlington, TX 76006-6190

Authorised official

Name: Mareeshia E Wilkins
Title: Owner
Phone: (817) 899-3054

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X Licence 226797 (TX)

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Registry record

NPI: 1023543048
Entity type: Organization
NPI issued: 27 Apr 2017
Record last updated: 27 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.