Organization
CONNIES MASTECTOMY BOUTIQUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONSTANCE B CRIDER (PRESIDENT, TREASURER, DIRECTOR)
(352) 795-5223
Entity
Organization
Contact information
Practice address
430 NE 3RD STREET, SUITE 1, CRYSTAL RIVER, FL 34429-4244
(352) 795-5223
(352) 795-6390
Mailing address
0430 NE 3RD ST, SUITE 1, CRYSTAL RIVER, FL 34429-4244
(352) 795-5223
(352) 795-6390
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
Other
Enumeration date
02/22/2007
Last updated
11/17/2008
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