| NPI | 1386307742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA CHRISTINE MIKELL Licensed Cosmetologist/Instructor 757-748-3527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2023-05-02 |