Organization
PRINCESS CORSET AND LINGERIE SHOP, LLC
Active
Organization
PRINCESS CORSET AND LINGERIE SHOP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE ANGELA JURGAITIS (PROPRIETOR)
(203) 755-3640
Entity
Organization
Contact information
Practice address
102 GRAND STREET, WATERBURY, CT 06702
(203) 755-3640
Mailing address
102 GRAND ST, WATERBURY, CT 06702-1909
(203) 755-3640
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/10/2010
Last updated
07/05/2012
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