NPI | 1407994148 |
---|---|
Doing Business As | MONUMENT WIGS & BREASTFORMS |
Entity Type | Organization |
Authorized Contact | JENNIE KAY BERRY Fitter 970-257-1317 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CO 23917970000) |
Enumeration Date | 2007-02-02 |
Last Update Date | 2009-03-19 |