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

Elegant Profile LLC

Organization Mastectomy Fitter · NPI 1194586115

Elegant Profile LLC is a Mastectomy Fitter in Winston Salem, North Carolina. Registered with an NPI since 2024.

In the registry since
2024
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

4622 Country Club Rd Ste 100
Winston Salem, NC 27104-3770
Phone: (336) 331-3480
Fax: (336) 793-1218
Show map & directions

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

Specialties & licences

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

Record details

NPI number1194586115
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Justine Juchter — Vice President · (336) 331-3480
NPI enumeratedJanuary 17, 2024
Last updated in NPPESApril 21, 2025
Certification dateApril 21, 2025
Mailing address4622 Country Club Rd Ste 100, Winston Salem, NC 27104-3770

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