Organization
THE HAIR LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE MATTEA JOHNSON (CRANIAL PROSTHESIS SPECIALIST)
(754) 213-1031
Entity
Organization
Contact information
Practice address
3449 NW 44TH ST APT 205, LAUDERDALE LAKES, FL 33309-4269
(754) 213-1031
Mailing address
3449 NW 44TH ST APT 205, LAUDERDALE LAKES, FL 33309-4269
(754) 213-1031
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/14/2024
Last updated
11/18/2024
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