| NPI | 1962112474 |
|---|---|
| Doing Business As | THE WIG REVIVER |
| Entity Type | Organization |
| Authorized Contact | MONICA ELLIOTT Owner 980-616-0374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-11-25 |
| Last Update Date | 2022-11-30 |