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Organization

HIDDEN SECRETS WIG & ACCESSORIES BOUTIQUE WEST INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBORAH KAYE VANDENBERG (CEO)
(616) 820-9221
Entity
Organization

Contact information

Practice address
11539 E LAKEWOOD BLVD, STE. 120, HOLLAND, MI 49424-7730
(616) 546-9444
(616) 546-9443
Mailing address
11539 E LAKEWOOD BLVD, STE. 120, HOLLAND, MI 49424-7730
(616) 546-9444
(616) 546-9443

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
335E00000X
MI

Other

Enumeration date
10/14/2009
Last updated
10/14/2009
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