Organization
CHILDREN WITH HAIR LOSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA VILLEMURE (FOUNDER/CEO)
(734) 379-4400
Entity
Organization
Contact information
Practice address
12776 DIXIE HWY, SOUTH ROCKWOOD, MI 48179-1001
(734) 379-4400
Mailing address
12776 DIXIE HWY, SOUTH ROCKWOOD, MI 48179-1001
(734) 379-4400
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41571
CFC
—
Enumeration date
06/09/2009
Last updated
04/30/2014
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