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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