Organization
THE FITTING ROOM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDITH ANN TAYLOR BOC CMF (PRESIDENT)
(440) 282-1145
Entity
Organization
Contact information
Practice address
1320 COOPER FOSTER PARK RD W, LORAIN, OH 44053-3614
(440) 282-1145
(440) 282-1165
Mailing address
1320 COOPER FOSTER PARK RD W, LORAIN, OH 44053-3614
(440) 282-1145
(440) 282-1165
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155880
ANTHEM
—
05
—
0196032
—
OH
01
—
5804421
AETNA
—
01
—
8000303
UNITEDHEALTH CARE
—
Enumeration date
11/09/2006
Last updated
03/19/2010
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