# A WIG BOUTIQUE ETC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013248806
- **Authorized official:** MICHELLE BLAKENEY (OWNER/OPERATOR)
- **Authorized official phone:** (850) 476-1916

## Contact information

- **Practice address:** 6707 PLANTATION RD, SUITE C3, PENSACOLA, FL 32504-6214
- **Practice address phone:** (850) 476-1916
- **Practice address fax:** (850) 476-1916
- **Mailing address:** 6707 PLANTATION RD, SUITE C3, PENSACOLA, FL 32504-6214
- **Mailing address phone:** (850) 476-1916
- **Mailing address fax:** (850) 476-1916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 660943 | FL | Yes |

## Other

- **Enumeration date:** 01/19/2010
- **Last updated:** 01/19/2010