Individual
PAIGE LYNN CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CF-M
Contact information
Practice address
1131 N DIXIE FWY, NEW SMYRNA, FL 32168-6069
(386) 427-6344
(855) 250-9392
Mailing address
1131 N DIXIE FWY, NEW SMYRNA, FL 32168-6069
(386) 427-6344
(855) 250-9392
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
CFM03368
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CFM03368
CERTIFIED FITTER-MASTECTOMY
—
Enumeration date
11/16/2020
Last updated
11/16/2020
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