Connies Mastectomy Boutique INC
NPI #1982739603 in Crystal River, Florida
Provider Information
- NPI Number
- 1982739603
- Entity Type
- Organization
- Organization Name
- Connies Mastectomy Boutique INC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Feb 22, 2007
- Last Updated
- Nov 17, 2008
Practice Location
- Address
- 430 NE 3RD STREET
- Address 2
- SUITE 1
- City
- Crystal River
- State
- Florida
- ZIP Code
- 34429-4244
- Phone
- (352) 795-5223
Authorized Official
- Name
- MRS. CONSTANCE B CRIDER
- Title
- PRESIDENT, TREASURER, DIRECTOR
- Phone
- (352) 795-5223
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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