| NPI | 1902582174 |
|---|---|
| Former Legal Business Name | EXTREME BEAUTY MEDICAL HAIR LOSS & MEDICAL WIG INC |
| Entity Type | Organization |
| Authorized Contact | FALESHA MARTIN CEO 717-327-8708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2024-05-10 |