| NPI | 1760637599 |
|---|---|
| Former Legal Business Name | BRANDIS HAIR COMPANY DBA BRANDIS WIG SALON |
| Entity Type | Organization |
| Authorized Contact | BRENDA K CONNOR Owner/President 904-771-7355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2008-11-20 |