Organization · Type 2 NPI

Recreate Mastectomy Products & Boutique

Prosthetic/Orthotic Supplier · Missoula, MT

NPI number 1740438696 Active

Practice location

116 South Ave W
Missoula, MT 59801-8116

Specialties and licenses

Taxonomy	Code	License
Prosthetic/Orthotic Supplier Primary	335E00000X	None listed

Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

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NPI record

NPI: 1740438696
Entity type: Organization (Type 2)
Issued: Sep 4, 2008
Last updated: Jul 24, 2009
Status: Active
Subpart: Yes of Missoula Orthotics & Prosthetics Laboratory, Inc.

Other names

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Recreate Mastectomy Products & Boutique · doing business as

Authorized official

Mrs. Karen J Williams, R.N.
Treasurer
(406) 549-0921

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1740438696

Recreate Mastectomy Products & Boutique's National Provider Identifier is 1740438696, issued on Sep 4, 2008. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Missoula, MT. The record was last updated on Jul 24, 2009.