Organization
MIZZ RAE'S LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARNIE R HARRIS (CEO - EXECUTIVE)
(617) 327-1041
Entity
Organization
Contact information
Practice address
5278 WASHINGTON ST., WEST ROXBURY, MA 02132
(617) 327-1041
Mailing address
5278 WASHINGTON ST, WEST ROXBURY, MA 02132-6338
(617) 327-1041
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/18/2007
Last updated
06/17/2008
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