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Organization
WAVE HAIR COLLECTION LLC
Active
Organization
WAVE HAIR COLLECTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI LILLESTOL (OWNER)
(941) 216-5184
Entity
Organization
Contact information
Practice address
14417 SUNDIAL PL, LAKEWOOD RANCH, FL 34202-5896
(941) 216-5184
Mailing address
14621 STATE ROAD 70 E # 235, LAKEWOOD RANCH, FL 34202-8403
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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