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Organization
BETTYS BOUTIQUE
Active
Organization
BETTYS BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY RAE SNIPES (OWNER)
(575) 762-1290
Entity
Organization
Contact information
Practice address
1013 PILE ST, CLOVIS, NM 88101-5940
(575) 762-1290
Mailing address
1013 PILE ST, CLOVIS, NM 88101-5940
(575) 762-1290
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
01885100002
NM
Other
Enumeration date
01/29/2008
Last updated
07/10/2008
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