| NPI | 1528571676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANITA JACKSON Manager/Hair Loss Specialist 312-286-3736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: IL 011-254633) |
| Enumeration Date | 2017-11-12 |
| Last Update Date | 2017-11-14 |