Origin Pregnancy Boutique
NPI #1255661583 in Mendocino, California
Provider Information
- NPI Number
- 1255661583
- Entity Type
- Organization
- Organization Name
- Origin Pregnancy Boutique
- Primary Specialty
- Radiologic Technologist - Sonography
- Enumeration Date
- Jan 8, 2010
- Last Updated
- Jan 8, 2010
Practice Location
- Address
- 45040 MAIN STREET
- Address 2
- B
- City
- Mendocino
- State
- California
- ZIP Code
- 95460
- Phone
- (707) 937-1477
Authorized Official
- Name
- AMY DAVIS, RDMS
- Title
- OWNER/SONOGRAPHER
- Phone
- (707) 937-1477
Specialties & Taxonomy Codes
| Specialty |
|---|
| Radiologic Technologist - Sonography — Sonography |
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