| NPI | 1588197263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA RENEE LONG Certified Hair Loss Specialist 856-240-1095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NJ 32WG06189000) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |