| NPI | 1801341805 |
|---|---|
| Doing Business As | DETOX LAB |
| Entity Type | Organization |
| Authorized Contact | VICTOR SAGALOVSKY President 808-938-4761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335G00000X Medical Foods Supplier |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |