| NPI | 1568459014 |
|---|---|
| Doing Business As | COCOS BOUTIQUE & SPECIALTY SHOPPE |
| Entity Type | Organization |
| Authorized Contact | THERESA HESTER JOHNSON Company President Owner Fitter 219-836-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2020-08-22 |