Organization
LADY GRACE STORES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE I GREEN (TREASURER)
(781) 322-1721
Entity
Organization
Contact information
Practice address
753 GRANITE ST, BRAINTREE, MA 02184-5328
(781) 848-6188
Mailing address
753 GRANITE ST, BRAINTREE, MA 02184-5328
(781) 848-6188
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
MA
Other
Enumeration date
06/12/2009
Last updated
06/12/2009
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