Provider Demographics
NPI:1194918011
Name:WILLETT COLLECTIONS, LLC
Entity type:Organization
Organization Name:WILLETT COLLECTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WILLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-523-6404
Mailing Address - Street 1:22634 ROYAL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-8781
Mailing Address - Country:US
Mailing Address - Phone:813-909-2353
Mailing Address - Fax:877-617-8003
Practice Address - Street 1:24420 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-7303
Practice Address - Country:US
Practice Address - Phone:813-909-2353
Practice Address - Fax:877-617-8003
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLETT COLLECTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-23
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier