Provider Demographics
NPI:1225201619
Name:CINDY LOU HISLE LLC
Entity type:Organization
Organization Name:CINDY LOU HISLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:HISLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-883-8885
Mailing Address - Street 1:2495 BRUNSWICK PIKE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4099
Mailing Address - Country:US
Mailing Address - Phone:609-883-8885
Mailing Address - Fax:609-883-8885
Practice Address - Street 1:2495 BRUNSWICK PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4099
Practice Address - Country:US
Practice Address - Phone:609-883-8885
Practice Address - Fax:609-883-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier