Organization
WIGS AND HAIR EXTENSIONS OF SARASOTA INC.
Active
Other names
Sarasota Mastectomy Products.com
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY J OLEVSON WIGS & BREAST FORMS (PRESIDENT)
(941) 600-6387
Entity
Organization
Contact information
Practice address
2412 STICKNEY POINT ROAD, SARASOTA, FL 34231
(941) 600-6387
Mailing address
2412 STICKNEY POINT ROAD, SARASOTA, FL 34231
(941) 600-6387
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CL1225850
FL
332B00000X
Durable Medical Equipment & Medical Supplies
400279
FL
Other
Enumeration date
03/26/2012
Last updated
11/25/2015
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