Organization
CUTTUPNDYED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSSIA CASSANDRA EDWARDS CERTIFIED HAIR LOSS (SPECIALIST)
(443) 453-7889
Entity
Organization
Contact information
Practice address
14110 BURWELLS BAY RD, SMITHFIELD, VA 23430-3711
(443) 453-7889
Mailing address
14110 BURWELLS BAY RD, SMITHFIELD, VA 23430-3711
(443) 453-7889
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
03/25/2015
Last updated
03/25/2015
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