| NPI | 1538857115 |
|---|---|
| Former Legal Business Name | KEAVA'S HAIR CASTLE LLC |
| Entity Type | Organization |
| Authorized Contact | CARRIE B RAWLS Medical Wig Provider 804-365-2102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-05-01 |