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1639769862
JELISSA NICOLE
DALLAS, TX
NPI
1639769862
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Entity Type
Organization
Authorized Contact
JELISSA BATES
Owner
214-497-8580
Organization Subpart ?
No
Primary Taxonomy
335E00000X Prosthetic/Orthotic Supplier
Enumeration Date
2021-01-21
Last Update Date
2021-01-21
Business Address
JELISSA NICOLE
18880 MARSH LN APT 1902
DALLAS, TX 75287-2241
Phone number: 214-497-8580
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Mailing Address
JELISSA NICOLE
18880 MARSH LN APT 1902
DALLAS, TX 75287-2241
Phone number: 214-497-8580
Copy
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