OrganizationActive
Birch Boutique LLC
NPI 1154045888 · Mastectomy Fitter · Antigo, WI
Provider details
- NPI number
- 1154045888
- Entity type
- Organization
- Primary specialty
- Mastectomy FitterRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Authorized official
- Greta Tomany, Owner
Practice location
612 Clemont St
Ste #8
Antigo, WI 54409-1988
Phone: (715) 350-7174
Fax: (715) 716-4330
Mailing address
612 Clemont St
Antigo, WI 54409-1988
Registry dates
- Enumerated
- 2022-09-27
- Last updated
- 2024-02-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.