| NPI | 1851045751 |
|---|---|
| Doing Business As | IMAGE BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | NATALIE MARIE REYNOLDS Manager Of Reimbursement 706-828-6430 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2022-02-09 |