Organization
CAROL'S PERSONAL MASTECTOMY BOUTIQUE OF SOUTHERN UTAH LLC
Active
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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