Organization
JACQUE MONAE LLC
Active
Other names
J.Monae Wigs & Hair Loss Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUE MCKENZIE (OWNER)
(470) 599-3145
Entity
Organization
Contact information
Practice address
4955 SUGARLOAF PKWY STE 104, LAWRENCEVILLE, GA 30044-8838
(470) 599-3145
Mailing address
3984 CHURCH VIEW LN, SUWANEE, GA 30024-8430
(470) 599-3145
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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