Organization
MONIQUE RENEE WIGS AND ETC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICKA LEWIS CERTIFIED HAIRLOSS (CERTIFIED HAIRLOSS SPECIALIST)
(816) 308-0132
Entity
Organization
Contact information
Practice address
12123 BLUE RIDGE EXT STE C, GRANDVIEW, MO 64030-1194
(816) 499-2233
Mailing address
12123 BLUE RIDGE EXT STE C, GRANDVIEW, MO 64030-1194
(816) 499-2233
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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