Organization
ITS JAZZY SALO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA MORRIS (CERTIFIED HAIR LOSS PROFESSIONAL)
(813) 415-7526
Entity
Organization
Contact information
Practice address
3010 N 22ND ST, TAMPA, FL 33605-1914
(813) 241-1400
Mailing address
3010 N 22ND ST, TAMPA, FL 33605
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CL1212955
FL
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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