| NPI | 1639789340 |
|---|---|
| Doing Business As | SHANTISE MICHELLE CRANIAL PROSTHESIS |
| Entity Type | Organization |
| Authorized Contact | SHANTISE PARKER Owner 973-901-3640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2024-02-09 |