Robertas Lovely Ladies Boutique

NPI #1376508309 in Alton, Illinois

Provider Information

NPI Number: 1376508309
Entity Type: Organization
Organization Name: Robertas Lovely Ladies Boutique
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Apr 20, 2006
Last Updated: Jun 18, 2015

Practice Location

Address: 603 WEST DELMAR
City: Alton
State: Illinois
ZIP Code: 62002
Phone: (618) 467-0640

Authorized Official

Name: MRS. ROBERTA J JAYNES
Title: OWNER SOLE PROPIETOR
Phone: (618) 467-0640

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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