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Organization
LAVANT GARDE HAIR
Active
Organization
LAVANT GARDE HAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAI PERRY (OPERATIONS MANAGER)
(203) 257-9279
Entity
Organization
Contact information
Practice address
580 NEWFIELD AVE, BRIDGEPORT, CT 06607-1718
(203) 257-9279
Mailing address
580 NEWFIELD AVE, BRIDGEPORT, CT 06607-1718
(203) 257-9279
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NULL
Other
Enumeration date
10/27/2016
Last updated
10/27/2016
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