| NPI | 1124568571 |
|---|---|
| Doing Business As | THE MASTECTOMY BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | IISHA K BAILEY Manager 504-758-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261Q00000X |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2022-07-21 |