OrganizationActive
Lady Grace Stores, Inc.
NPI 1700013935 · Prosthetic/Orthotic Supplier · South Portland, ME
Provider details
- NPI number
- 1700013935
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Bruce Green, Treasurer(781) 322-1721
Specialties & taxonomies
Suppliers
Practice location
343 Gorham Rd
South Portland, ME 04106-2317
Phone: (207) 774-8139
Approximate (ZIP-level) locationGet directions
Mailing address
343 Gorham Rd
South Portland, ME 04106-2317
Registry dates
- Enumerated
- 2009-06-15
- Last updated
- 2009-06-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.