Provider Demographics
NPI:1205689148
Name:GRINDELS BEAUTIFUL YOU LLC
Entity type:Organization
Organization Name:GRINDELS BEAUTIFUL YOU LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRINDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-331-7128
Mailing Address - Street 1:379 NICHOLS AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-3905
Mailing Address - Country:US
Mailing Address - Phone:203-331-7128
Mailing Address - Fax:
Practice Address - Street 1:379 NICHOLS AVE
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-3905
Practice Address - Country:US
Practice Address - Phone:203-331-7128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty