| NPI | 1639613185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYCE WOOTEN Certified Hair Loss Specialist 717-231-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist Prosthetics Case Management |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2016-12-16 |