Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers |
| NPI Number | 1508060443 |
| LBN Legal business name | VERNA LEE STIVENDER |
| Authorized official | LEE STIVENDER - (OWNER MASTECTOMY CERT FITTER AND CO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 06/13/2007 |
| Last updated | 04/29/2009 - About 17 years ago |
| Identifiers | n/a |
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