Organization
EXOTIC NOVA EXTENSIONS RX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY A LEE (OWNER)
(219) 617-3799
Entity
Organization
Contact information
Practice address
9445 INDIANAPOLIS BLVD # 1212, HIGHLAND, IN 46322-2648
(219) 617-3799
(219) 244-5596
Mailing address
8810 SUNFOREST LN, PEARLAND, TX 77584-2415
(219) 617-3799
(219) 244-5596
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/28/2021
Last updated
09/23/2024
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