Organization
LINDA L HICE
Active
Other names
Manelines Unique Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA L HICE (OWNER)
(704) 482-9938
Entity
Organization
Contact information
Practice address
1100 S LAFAYETTE ST, SHELBY, NC 28152-6708
(704) 482-9938
(704) 600-6433
Mailing address
1100 S LAFAYETTE ST, SHELBY, NC 28152-6708
(704) 482-9938
(704) 600-6433
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
CFM00159
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487690004
INDIVIDUAL NPI
NC
05
—
7795304
—
NC
Enumeration date
10/29/2013
Last updated
10/02/2015
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