Provider Demographics
NPI:1508191339
Name:PERSONAL TOUCH FITTING
Entity Type:Organization
Organization Name:PERSONAL TOUCH FITTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HANAK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:386-882-1161
Mailing Address - Street 1:3131 VICTORY PALM DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-6129
Mailing Address - Country:US
Mailing Address - Phone:386-882-1161
Mailing Address - Fax:
Practice Address - Street 1:851 DUNLAWTON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4233
Practice Address - Country:US
Practice Address - Phone:386-761-8711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT11571332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies