| NPI | 1568858421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS DOSS Hair Stylist 910-670-9662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: NC C74678) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |