A Beautiful You Mastectomy Boutique

NPI #1558760611 in Caldwell, Idaho

Provider Information

NPI Number
1558760611
Entity Type
Organization
Organization Name
A Beautiful You Mastectomy Boutique
Primary Specialty
Prosthetic/Orthotic Supplier
Enumeration Date
Aug 14, 2014
Last Updated
Nov 12, 2014

Practice Location

Address
2006 BLAINE ST
State
Idaho
ZIP Code
83605-4343
Phone
(208) 985-5404

Authorized Official

Name
MRS. LEANNE M KOVICK, CFM
Title
OWNER/OPERATOR
Phone
(208) 985-5404

Specialties & Taxonomy Codes

Specialty
Prosthetic/Orthotic Supplier

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