Organization
CARRESHA GOODLOW
Active
Other names
Charmaine cain hair replacement center
Organization subpart
No
Provider details
NPI number
Authorized official
CARRESHA CHARMAINE GOODLOW (C.E.O)
(731) 444-2577
Entity
Organization
Contact information
Practice address
820 MAIN ST, NORWAY, MI 49870-1250
(731) 444-2577
Mailing address
PO BOX 6561, MILWAUKEE, WI 53206-0561
(731) 444-2577
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
2701437960
MI
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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