Antoinette's Wigs & Daisy Boutique Mastectomy Appearl
NPI #1518155670 in Midlothian, Illinois
Provider Information
- NPI Number
- 1518155670
- Entity Type
- Organization
- Organization Name
- Antoinette's Wigs & Daisy Boutique Mastectomy Appearl
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Oct 13, 2007
- Last Updated
- Oct 13, 2007
Practice Location
- Address
- 4714 147TH ST
- City
- Midlothian
- State
- Illinois
- ZIP Code
- 60445-2527
- Phone
- (708) 385-5736
Authorized Official
- Name
- MISS PATRICIA M LEDDY
- Title
- OWNER/CERTIFIED FITTER
- Phone
- (708) 385-5736
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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