| NPI | 1073141164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA WRIGHT Trichologist 912-777-2517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |