NPI 1316047350

Lifeshapes Boutique INC

Organisation Prosthetic/Orthotic Supplier Brandon, FL

Practice location

Address: 518 Lakewood Dr, Brandon, FL 33510-4037
Phone: (813) 654-6968
Fax: (813) 655-6968

Authorised official

Name: Felicia Noriega Dickey
Title: Owner
Phone: (813) 629-6331

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1316047350
Entity type: Organization
NPI issued: 22 Sep 2006
Record last updated: 22 Aug 2020

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.