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Organization

FEELING BEAUTIFUL AGAIN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CORINNE DEROSALES (OWNER)
(707) 399-8511
Entity
Organization

Contact information

Practice address
1916 NEW JERSEY STREET, FAIRFIELD, CA 94533
(707) 399-8511
(707) 434-9826
Mailing address
1916 NEW JERSEY STREET, FAIRFIELD, CA 94533
(707) 399-8511
(707) 434-9826

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary

Other

Enumeration date
08/03/2011
Last updated
08/03/2011
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