Organization
BELLE MEDICAL WIG PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATHERNE ESPERANCE (OWNER)
(317) 918-9591
Entity
Organization
Contact information
Practice address
1300 E 86TH ST, INDIANAPOLIS, IN 46240-1910
(317) 918-9591
Mailing address
4047 BRAIDED STREAM WAY APT 1D, INDIANAPOLIS, IN 46268-3722
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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