A Beautiful You Mastectomy Boutique

NPI #1902202708 in Caldwell, Idaho

Provider Information

NPI Number: 1902202708
Entity Type: Organization
Organization Name: A Beautiful You Mastectomy Boutique
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Nov 6, 2014
Last Updated: Nov 6, 2014

Practice Location

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

Authorized Official

Name: LEANNE KOVICK, CFM
Title: PRESIDENT
Phone: (208) 985-5404

Specialties & Taxonomy Codes

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

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