| NPI | 1063925469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY PHILLIPS Full Lace Wigs &Frontal Specialist 843-901-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 5889) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |