| NPI | 1720159452 |
|---|---|
| Doing Business As | STACEY'S MASTECTOMY CENTER |
| Entity Type | Organization |
| Authorized Contact | STACEY ANN BURNS-FOX President 515-270-1399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2022-06-09 |