Provider Information for 1700629565
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FRIEND IN BOX INC FIAB
Other Names:Other Name:F.I.A.B.Organization Subpart: NO
NPI: 1700629565
Last Updated: 2025-02-25
Certification Date: 2025-02-25
Certification Date: 2025-02-25
Details
Name | Value | ||||||||
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NPI | 1700629565 | ||||||||
Enumeration Date | 2024-06-18 | ||||||||
NPI Type | NPI-2 Organization | ||||||||
Status | Active | ||||||||
Authorized Official Information | Name: Mrs. SHERIE REGINA MAWUSI Title: Owner Phone: 7573158039 | ||||||||
Mailing Address | 15 RESEARCH DR STE A HAMPTON, VA 23666-1324 United States Phone: 757-315-8039 | Fax:757-902-1629 | ||||||||
Primary Practice Address | 15 RESEARCH DR STE A HAMPTON, VA 23666-1324 United States Phone: 757-315-8039 | Fax:757-902-1629 | ||||||||
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