Organization
5TH AVENUE GROOMING LOUNGE
Active
Organization
5TH AVENUE GROOMING LOUNGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAREESHIA E WILKINS (OWNER)
(817) 899-3054
Entity
Organization
Contact information
Practice address
1201 N WATSON RD., SUITE 283, ARLINGTON, TX 76116
(817) 899-3054
Mailing address
1201 N WATSON RD, STE 283, ARLINGTON, TX 76006-6190
(817) 899-3054
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
226797
TX
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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