Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Birch Boutique LLC

Organization Mastectomy Fitter · NPI 1154045888

Birch Boutique LLC is a Mastectomy Fitter in Antigo, Wisconsin. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

612 Clemont St Ste #8
Antigo, WI 54409-1988
Phone: (715) 350-7174
Fax: (715) 716-4330
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mastectomy Fitter (primary) Taxonomy 224900000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1154045888
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Greta Tomany — Owner · (715) 350-7174
NPI enumeratedSeptember 27, 2022
Last updated in NPPESFebruary 29, 2024
Certification dateFebruary 29, 2024
Mailing address612 Clemont St, Ste #8, Antigo, WI 54409-1988

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