# MIZZ RAE'S LLC

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

## Provider details

- **NPI number:** 1528242237
- **Authorized official:** MRS. MARNIE R HARRIS (CEO - EXECUTIVE)
- **Authorized official phone:** (617) 327-1041

## Contact information

- **Practice address:** 5278 WASHINGTON ST., WEST ROXBURY, MA 02132
- **Practice address phone:** (617) 327-1041
- **Mailing address:** 5278 WASHINGTON ST, WEST ROXBURY, MA 02132-6338
- **Mailing address phone:** (617) 327-1041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 12/18/2007
- **Last updated:** 06/17/2008