| NPI | 1942677273 |
|---|---|
| Doing Business As | VIRGIN GIRL HAIR MEDICAL PROSTHESIS |
| Entity Type | Organization |
| Authorized Contact | RUSSELL MARCILIS Owner 313-799-7935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2015-12-30 |