Organization
MEDICAL HAIR RESTORATION BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANISHA ALINA JOHNSON (EXECUTIVE DIRECTOR)
(414) 315-4559
Entity
Organization
Contact information
Practice address
1913 N 37TH ST, MILWAUKEE, WI 53208-1802
(414) 315-4559
(414) 315-4559
Mailing address
1913 N 37TH ST, MILWAUKEE, WI 53208-1802
(414) 315-4559
(414) 315-4559
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/04/2026
Last updated
04/10/2026
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