Extensions Of You Mastectomy Boutique
Prosthetic/Orthotic Supplier in Metairie, LA. Organization (NPI-2).
NPI number1144906751
StatusActive
Last updated in NPPESJun 17, 2025
Details
- NPI
- 1144906751
- Entity type
- Organization (NPI-2)
- Legal business name
- Extensions Of You Mastectomy Boutique
- Organization subpart
- No
- Enumeration date
- Jun 27, 2023
- Certification date
- Jun 17, 2025
- Last updated
- Jun 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Practice location
3100 Cleary Ave Ste 2Metairie, LA 70002-5749
Phone 504-635-9860
Mailing address
3100 Cleary Ave Ste 2Metairie, LA 70002-5749
Phone 504-635-9860
Authorized official
Trischel D Davis
Certified Mastectomy Fitter
5046359860
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All 10 Prosthetic/Orthotic Supplier providers in Metairie · All 7,185 providers in Metairie
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