Provider Demographics
NPI:1538357660
Name:P.S. NAILS AND ETC
Entity type:Organization
Organization Name:P.S. NAILS AND ETC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-892-6346
Mailing Address - Street 1:480 GREENWAY VIEW DR
Mailing Address - Street 2:SUITE 119
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5693
Mailing Address - Country:US
Mailing Address - Phone:423-892-6346
Mailing Address - Fax:423-892-6347
Practice Address - Street 1:480 GREENWAY VIEW DR
Practice Address - Street 2:SUITE 119
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5693
Practice Address - Country:US
Practice Address - Phone:423-892-6346
Practice Address - Fax:423-892-6347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN88243335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier