Organization
NEW IMAGES BOUTIQUE CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN A SIMS CPO (OWNER)
(501) 321-0552
Entity
Organization
Contact information
Practice address
222 CORNERSTONE BLVD, HOT SPRINGS, AR 71913-6564
(501) 321-0552
(501) 321-0849
Mailing address
222 CORNERSTONE BLVD, HOT SPRINGS, AR 71913-6564
(501) 321-0552
(501) 520-0255
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123073716
—
AR
01
—
48580
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/14/2006
Last updated
03/18/2014
Update your record
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