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Organization

LAVENDER WISP LINGERIE CO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA M. JONES (PARTNER OWNER)
(973) 623-8161
Entity
Organization

Contact information

Practice address
78 RICHMOND STREET, NEWARK, NJ 07103
(973) 623-8665
(973) 623-8665
Mailing address
78 RICHMOND STREET, NEWARK, NJ 07103
(973) 623-8665
(973) 623-8665

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
04/29/2008
Last updated
07/15/2008
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