Organization
EXPERIENCE LEMIEUX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASHLEY EDWARDS (OWNER)
(267) 997-1096
Entity
Organization
Contact information
Practice address
900 N 19TH ST UNIT 3247, PHILADELPHIA, PA 19130-1561
(267) 997-1096
(855) 375-7029
Mailing address
900 N 19TH ST UNIT 3247, PHILADELPHIA, PA 19130-1561
(267) 997-1096
(855) 375-7029
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
839670
LLC
PA
Enumeration date
04/15/2020
Last updated
04/15/2020
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