Organization
RECREATE MASTECTOMY PRODUCTS & BOUTIQUE
Active
Parent organization
MISSOULA ORTHOTICS & PROSTHETICS LABORATORY, INC.
Other names
ReCreate Mastectomy Products & Boutique
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSOULA ORTHOTICS & PROSTHETICS LABORATORY, INC.
Authorized official
MRS. KAREN J WILLIAMS R.N. (TREASURER)
(406) 549-0921
Entity
Organization
Contact information
Practice address
116 SOUTH AVE W, MISSOULA, MT 59801-8116
(406) 721-4242
Mailing address
116 SOUTH AVE W, MISSOULA, MT 59801-8116
(406) 721-4242
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/04/2008
Last updated
07/24/2009
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