Madeline Rose Mastectomy Boutique, LLC
Madeline Rose Mastectomy Boutique, LLC is a Mastectomy Fitter in Vestal, New York. 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.
Practice location Address checks out
100 Rano BlvdVestal, NY 13850-2776
Phone: (607) 296-2021
Fax: (607) 296-2023
Show map & directions
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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 number | 1316693765 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jamie Walck — Owner · (607) 296-2021 |
| NPI enumerated | February 24, 2022 |
| Last updated in NPPES | July 26, 2022 |
| Certification date | May 31, 2022 |
| Mailing address | 100 Rano Blvd, Vestal, NY 13850-2776 |
Other providers in Vestal
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Mrs. Jamie Leigh Walck
100 Rano Blvd, Vestal, NY 13850-2776 · (607) 296-2021