| NPI | 1306029681 |
|---|---|
| Doing Business As | THE BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | JENNIFER MICHELLE SMITH Secretary 336-687-9220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2007-12-10 |