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Organization

PRETTY ESSENTIALS WOMEN'S BOUTIQUE, LLC.

Active
Other names
Pretty Essentials Women's Boutique
Organization subpart
No

Provider details

NPI number
Authorized official
KEISHIA JUSTICE (CHIEF EXECUTIVE OFFICER/MEMBER)
(919) 274-2461
Entity
Organization

Contact information

Practice address
661 TIFFANY BLVD, ROCKY MOUNT, NC 27804-1802
(919) 274-2461
Mailing address
661 TIFFANY BLVD, ROCKY MOUNT, NC 27804-1802
(252) 442-4233
(252) 557-3557

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
05/13/2021
Last updated
12/20/2023
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