Organization
LADY IN PINK MASTECTOMY BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON KAY MAGILL (OFFICE MANAGER/BILLER)
(361) 334-3476
Entity
Organization
Contact information
Practice address
1241 NILE DRIVE, CORPUS CHRISTI, TX 78412
(361) 334-3476
(361) 334-3461
Mailing address
1241 NILE DRIVE, CORPUS CHRISTI, TX 78412
(361) 334-3476
(361) 334-3461
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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