Organization
MAGNOLIAS POST-MASTECTOMY BOUTIQUE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERRYL A JEDELE (SINGLE MEMBER / OWNER)
(317) 831-3220
Entity
Organization
Contact information
Practice address
625 S STATE ROAD 67, MOORESVILLE, IN 46158-2797
(317) 831-3220
(317) 831-3321
Mailing address
625 S STATE ROAD 67, MOORESVILLE, IN 46158-2797
(317) 831-3220
(317) 831-3321
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/19/2009
Last updated
03/19/2009
About Stedi
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