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Organization
BOOB SHOP
Active
Organization
BOOB SHOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE STRACHAN (PRESIDENT)
(757) 706-5571
Entity
Organization
Contact information
Practice address
4900 BROADWAY ST STE 700, SAN ANTONIO, TX 78209-5739
(757) 706-5571
Mailing address
250 TREELINE PARK APT 302, SAN ANTONIO, TX 78209-7401
(757) 706-5571
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
05/07/2020
Last updated
07/24/2020
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