Organization
SURVIVORS BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE KUNNARY CFM (PRESIDENT)
(406) 422-0898
Entity
Organization
Contact information
Practice address
1054 HELENA AVE, HELENA, MT 59601
(406) 422-0898
Mailing address
1054 HELENA AVE, HELENA, MT 59601
(406) 422-0898
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/09/2017
Last updated
09/19/2017
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