Organization
MILK MOMS, INC
Active
Other names
Heather's Mastectomy Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
DENZEL URAM (VICE PRESIDENT)
(763) 314-2096
Entity
Organization
Contact information
Practice address
1714 BUNKER LAKE BLVD NW STE 102, ANDOVER, MN 55304-4091
(763) 314-2004
Mailing address
13783 IBIS ST NW STE 200, ANDOVER, MN 55304-7649
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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