Organization
THE MANE MASTERPIECE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKAYLA MCMATH (OWNER)
(616) 916-9909
Entity
Organization
Contact information
Practice address
5357 WYNDTREE LN SE, GRAND RAPIDS, MI 49548-0837
(616) 916-9909
Mailing address
5357 WYNDTREE LN SE, GRAND RAPIDS, MI 49548-0837
(616) 916-9909
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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