| NPI | 1770763765 |
|---|---|
| Doing Business As | BOUTIQUE OF JBACC |
| Entity Type | Organization |
| Authorized Contact | CHARLES W ADAMS Director Of Retail 706-987-3872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |