| NPI | 1093533051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA G LEWIS-TUNSIL Master Cosmetologist 336-405-7101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |