Provider Demographics
NPI:1659737146
Name:BEAUTIFULLY UNIQUE, LLC
Entity Type:Organization
Organization Name:BEAUTIFULLY UNIQUE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:BORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-312-8733
Mailing Address - Street 1:2716 BROOKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5636
Mailing Address - Country:US
Mailing Address - Phone:269-270-3589
Mailing Address - Fax:269-312-8161
Practice Address - Street 1:2004 INVERWAY CT
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1710
Practice Address - Country:US
Practice Address - Phone:269-312-8733
Practice Address - Fax:269-312-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier