Organization
E.M. EXOTIC HAIR CREATION & SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EVELYN METELLUS HAIR LOSS SPECIALIST (PRESIDENT)
(561) 574-0597
Entity
Organization
Contact information
Practice address
10300 FOREST HILL BLVD STE 270, WELLINGTON, FL 33414-3130
(561) 200-2820
Mailing address
10300 FOREST HILL BLVD, WELLINGTON, FL 33414-3120
(561) 200-2820
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CE10000534
FL
Other
Enumeration date
06/08/2017
Last updated
10/26/2022
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