| NPI | 1003578113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEYONTA NEWSOME Certified Hair Loss Specialist 313-475-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2021-10-06 |