| NPI | 1780134965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARANDA BROWN DAVIS Hair Loss Specialist 803-730-0231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |