Organization
E-DEE'S PENNYRICH BRA SALON
Active
Organization
E-DEE'S PENNYRICH BRA SALON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EDITH SUPANICH (OWNER)
(313) 383-3428
Entity
Organization
Contact information
Practice address
8043 ALLEN RD, ALLEN PARK, MI 48101-1705
(313) 381-0810
Mailing address
8043 ALLEN RD, ALLEN PARK, MI 48101-1705
(313) 381-0810
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
05/16/2008
Last updated
05/16/2008
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