| NPI | 1710152798 |
|---|---|
| Doing Business As | PROVIDENCE TRANSITIONS-THE MARY CLARK APPEARANCE CENTER |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Corp Secretary For Enrollments 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2018-12-06 |