| NPI | 1093153264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY LYKE Certified Trichology Practictioner 702-807-1498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2016-04-22 |