Organization · Type 2 NPI

Stacey's Bra and Lingerie Shop, Inc

Prosthetic/Orthotic Supplier · Urbandale, IA

NPI number 1720159452 Active

Practice location

10453 Hickman Road
Urbandale, IA 50322-5032

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Prosthetic/Orthotic Supplier Primary	335E00000X	None listed

Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

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NPI record

NPI: 1720159452
Entity type: Organization (Type 2)
Issued: Nov 13, 2006
Last updated: Jun 9, 2022
Status: Active

Other names

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Stacey's Mastectomy Center · doing business as
Stacey's Mastectomy Center · doing business as

Authorized official

Stacey Ann Burns-Fox, CFM
President
(515) 270-1399

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1720159452

Stacey's Bra and Lingerie Shop, Inc's National Provider Identifier is 1720159452, issued on Nov 13, 2006. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Urbandale, IA. The record was last updated on Jun 9, 2022.