Organization
FOUR SISTERS LLC
Active
Other names
Foundations Professional Bra Fitting
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA LOGOS CMF (OWNER)
(228) 424-1913
Entity
Organization
Contact information
Practice address
9138 CARL LEGETT RD STE C, GULFPORT, MS 39503-6262
(228) 896-3688
(228) 896-3688
Mailing address
9138 CARL LEGETT RD STE C, GULFPORT, MS 39503-6262
(228) 896-3688
(228) 896-3688
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
03/15/2022
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