Organization
LEGORAS CONTURE FASHIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LEGORA ALVERTA MARKLE (DIRECT OWNER)
(260) 483-1614
Entity
Organization
Contact information
Practice address
3316 INWOOD DRIVE, FORT WAYNE, IN 46815
(260) 483-1614
(260) 471-7374
Mailing address
3316 INWOOD DRIVE, FORT WAYNE, IN 46815
(260) 483-1614
(260) 471-7374
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100181100A
—
IN
01
—
28226285
RN
IN
Enumeration date
03/01/2007
Last updated
08/14/2008
Update your record
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