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Organization

SASSY SISTAS BOUTIQUE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EBONI RAINEY-HAYNES (CO-OWNER)
(407) 383-0643
Entity
Organization

Contact information

Practice address
851 W STATE ROAD 436 STE 1005, ALTAMONTE SPRINGS, FL 32714-3055
(407) 383-0643
Mailing address
851 W STATE ROAD 436 STE 1005, ALTAMONTE SPRINGS, FL 32714-3055
(407) 383-0643

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
02/17/2022
Last updated
03/04/2024
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