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Organization

YONGS WIG SALON,INC

Active
Parent organization
YONGS WIG SALON ,INC
Other names
Yongs Mastectomy Products
Organization subpart
Yes

Provider details

NPI number
Legal business name
YONGS WIG SALON ,INC
Authorized official
YONG S CORCORAN (PRESIDENT)
(321) 638-8832
Entity
Organization

Contact information

Practice address
1834 US HIGHWAY 1, ROCKLEDGE, FL 32955-2822
(321) 638-8832
(321) 631-8022
Mailing address
1834 US HIGHWAY 1, ROCKLEDGE, FL 32955-2822
(321) 638-8832
(321) 631-8022

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
1580119145924
FL
332B00000X
Durable Medical Equipment & Medical Supplies
335E00000X
Prosthetic/Orthotic Supplier
Primary
1580119145924
FL

Other

Enumeration date
04/15/2015
Last updated
09/27/2019
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