Organization
MEDICAL WIG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE CLARK CRANIAL PROSTHESIS (CEO)
(800) 342-9913
Entity
Organization
Contact information
Practice address
2424 W OAKLAND PARK BLVD STE 109, OAKLAND PARK, FL 33311-1414
(800) 342-9913
Mailing address
4301 S FLAMINGO RD STE 106, DAVIE, FL 33330-1902
(800) 342-9913
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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