Origin Pregnancy Boutique is a health care provider in Fort Bragg, CA. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location||45040 Main Street, B, Mendocino, CA 95460, US|
|Practice Location Phone||707-937-1477|
|Practice Location Fax||707-937-1480|
|Legal Business Name||ORIGIN PREGNANCY BOUTIQUE|
|Enumeration Date ?||Jan 8, 2010|
|Last Update Date ?||Jan 8, 2010|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
|Specialty||Provider Type||Specialization||License||License State|
|Radiologic Technologist||Technologists, Technicians & Other Technical Service Providers||Sonography||RDMS81478||California|
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Origin Pregnancy Boutique's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official||Amy Davis (RDMS)|
|Authorized Official Title/Position||OWNER/SONOGRAPHER|
|Authorized Official Phone Number||707-937-1477|