Organization
THE PINK DOOR BOUTIQUE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIRDRE SHEAD (OWNER)
(314) 600-1005
Entity
Organization
Contact information
Practice address
1623 VIEW WOODS DR, KIRKWOOD, MO 63122-3522
(314) 822-8255
Mailing address
1623 VIEW WOODS DR, KIRKWOOD, MO 63122-3522
(314) 822-8255
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
LC1085182
MO
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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