Organization
MELANATED HAIR NATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IKEIRA SEALIE (CREDENTIALING MGR)
(360) 209-3440
Entity
Organization
Contact information
Practice address
11356 WORMER, REDFORD, MI 48239-1625
(313) 605-7033
Mailing address
11356 WORMER, REDFORD, MI 48239-1625
(313) 605-7033
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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