Organization
PRINCESS MANES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATISHA MILLER (OWNER)
(612) 743-2688
Entity
Organization
Contact information
Practice address
4171 LYNDALE AVE N, MINNEAPOLIS, MN 55412-1737
(612) 451-9721
Mailing address
3123 RUSSELL AVE N # 1, MINNEAPOLIS, MN 55411-1018
(612) 743-2688
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/07/2024
Last updated
07/28/2025
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