Provider Demographics
NPI:1538589304
Name:ALLINFAVOR, INC.
Entity type:Organization
Organization Name:ALLINFAVOR, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:262-989-9629
Mailing Address - Street 1:316 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1029
Mailing Address - Country:US
Mailing Address - Phone:262-554-5991
Mailing Address - Fax:262-554-1293
Practice Address - Street 1:2721 S GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-4949
Practice Address - Country:US
Practice Address - Phone:262-554-5991
Practice Address - Fax:262-554-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2990-35332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier