Organization
ENHANCED AESTHETICS AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRIA GREEN FNP-BC (OWNER / PROVIDER)
(985) 778-7582
Entity
Organization
Contact information
Practice address
367 S ACADEMY LN, EAGLE, ID 83616-7470
(985) 778-7582
Mailing address
367 S ACADEMY LN, EAGLE, ID 83616-7470
(985) 778-7582
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/25/2023
Last updated
12/26/2023
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