NPI 1265669477

Lady Grace Stores, INC.

Organisation Prosthetic/Orthotic Supplier Waltham, MA

Practice location

Address: 108 River St, Waltham, MA 02453-8306
Phone: (781) 894-2081

Authorised official

Name: Bruce I Green
Title: Treasurer
Phone: (781) 322-1721

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1265669477
Entity type: Organization
NPI issued: 15 Jun 2009
Record last updated: 15 Jun 2009

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.