| NPI | 1952417859 |
|---|---|
| Doing Business As | LADY JANE MASTECTOMY BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | SUSAN SCHEFTIC Owner 315-498-9086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2011-12-27 |