| NPI | 1720696479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY FERGUSON Hair Loss Specialist 469-970-2758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |