OrganizationActive
Roberta'S Lovely Ladies Boutique
NPI 1174983050 · Mastectomy Fitter · Alton, IL
Provider details
- NPI number
- 1174983050
- Entity type
- Organization
- Primary specialty
- Mastectomy FitterRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Carol Logan, Owner(618) 467-0095
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
603 W. Delmar
Alton, IL 62002
Phone: (618) 467-0640
Approximate (ZIP-level) locationGet directions
Mailing address
603 W. Delmar
Alton, IL 62002
Registry dates
- Enumerated
- 2016-03-04
- Last updated
- 2016-03-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.