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Organization

SEXY-N-LACE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BRIDGET REYNOLDS REYNOLDS (OWNER)
(678) 516-2157
Entity
Organization

Contact information

Practice address
4230 ETOWAH DR SE, ACWORTH, GA 30102-3108
(678) 516-2157
(866) 249-3717
Mailing address
4230 ETOWAH DRIVE SE, ACWORTH, GA 30102-3108
(678) 516-2157
(866) 249-3717

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
05/12/2010
Last updated
05/12/2010
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