Organization
AT LAST BRA AND LINGERIE BOUTIQUE LLC
Active
Other names
AT LAST... BRAS, A MASTECTOMY BOUTIQUE
Organization subpart
No
Provider details
NPI number
Authorized official
BENITA LEICHELLE KIMBALL CMF (OWNER)
(916) 480-9501
Entity
Organization
Contact information
Practice address
1329 HOWE AVE STE 101, SACRAMENTO, CA 95825-3363
(916) 480-9501
(916) 800-8271
Mailing address
1329 HOWE AVE STE 101, SACRAMENTO, CA 95825-3363
(916) 480-9501
(916) 514-8991
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
C52184
CA
Other
Enumeration date
02/09/2016
Last updated
04/04/2025
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