Healthcare Provider Details

I. General information

NPI: 1659670990
Provider Name (Legal Business Name): A PERFECT FIT BOUTIQUE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1853 BATTLEFIELD PKWY
FT. OGLETHORPE GA
30742-5166
US

IV. Provider business mailing address

1853 BATTLEFIELD PKWY
FORT OGLETHORPE GA
30742-4021
US

V. Phone/Fax

Practice location:
  • Phone: 706-858-0710
  • Fax: 706-858-0810
Mailing address:
  • Phone: 706-858-0710
  • Fax: 706-858-0810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL KUEBLER
Title or Position: OWNER
Credential:
Phone: 706-858-0710