| NPI | 1861848137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENISHA YVONNE BIBBS Trichologist/Hair Loss Practitioner 470-209-4671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |