Organization
WIGIT BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA A FOILES (OWNER)
(817) 864-9447
Entity
Organization
Contact information
Practice address
3214 HARWOOD RD, BEDFORD, TX 76021-3902
(817) 864-9447
(817) 864-9997
Mailing address
3214 HARWOOD RD, BEDFORD, TX 76021-3902
(817) 864-9447
(817) 864-9997
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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