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Organization

CAROL'S PERSONAL MASTECTOMY BOUTIQUE OF SOUTHERN UTAH LLC

Active
Other names
Carols Post Mastectomy Spec
Organization subpart
No

Provider details

NPI number
Authorized official
JENNNIFER FLOWERS CFM (OWNER)
(435) 688-0452
Entity
Organization

Contact information

Practice address
1490 E FOREMASTER DR STE 310, ST GEORGE, UT 84790-4504
(435) 688-0452
(435) 688-0453
Mailing address
1490 E FOREMASTER DR STE 310, ST GEORGE, UT 84790-4504
(435) 688-0452
(435) 688-0453

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
UT
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
09/20/2006
Last updated
08/16/2021
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