Organization
PARK MEDICAL WEAR, INC.
Active
Other names
Park Mastectomy Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DAVID PARK (PRESIDENT)
(866) 699-9612
Entity
Organization
Contact information
Practice address
1697 FREEDOM CT, HENDERSON, NV 89014-7526
(866) 699-9612
(702) 405-7147
Mailing address
1697 FREEDOM CT, HENDERSON, NV 89014-7526
(866) 699-9612
(702) 405-7147
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
05/17/2011
Last updated
08/28/2013
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