Organization
MAGIQUE BOUTIQUE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE MARDIS (PRESIDENT)
(970) 230-5780
Entity
Organization
Contact information
Practice address
760 WHALERS WAY STE C120, FORT COLLINS, CO 80525-3372
(970) 230-5780
(970) 236-2596
Mailing address
760 WHALERS WAY STE C120, FORT COLLINS, CO 80525-3372
(970) 230-5780
(970) 236-2596
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/26/2024
Last updated
07/26/2024
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