| NPI | 1437746302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA MARCELL PETTIFORD Hair Loss Practitioner 443-858-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2020-12-28 |