Organization
BEAUTIFUL ME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE A. JOHNSON (OWNER)
(262) 723-5555
Entity
Organization
Contact information
Practice address
531 VALLEY VIEW DR, FONTANA, WI 53125-1198
(262) 275-5000
Mailing address
531 VALLEY VIEW DRIVE, FONTANA, WI 53125
(262) 275-5000
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
004-0002290200-01
WI
Other
Enumeration date
12/06/2007
Last updated
01/14/2008
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