NPI | 1558760611 |
---|---|
Doing Business As | A BEAUTIFUL YOU MASTECTOMY BOUTIQUE |
Entity Type | Organization |
Authorized Contact | LEANNE M KOVICK Owner/Operator 208-985-5404 |
Organization Subpart ? | No |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: ID CFm02746) |
Enumeration Date | 2014-08-14 |
Last Update Date | 2014-11-12 |