NPI 1699458380

Premier Mastectomy Vendor LLC

Organisation Mastectomy Fitter Montgomery, AL

Practice location

Address: 5911 Monticello Dr STE B, Montgomery, AL 36117-1940
Phone: (629) 279-5720

Authorised official

Name: Jasmine Bean
Title: Co-Owner
Phone: (629) 279-5270

Registered specialties (2)

Mastectomy Fitter Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224900000X

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Massage Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X

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Registry record

NPI: 1699458380
Entity type: Organization
NPI issued: 9 Aug 2023
Record last updated: 20 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.