| NPI | 1942337431 |
|---|---|
| Doing Business As | CANCER CENTER BOUTIQUE WW-1400 |
| Entity Type | Organization |
| Authorized Contact | MICHAEL E HALEY President/CEO 765-747-3251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-07-20 |