Organization
EVERLASTING IMPRESSIONS HAIR RESTORATION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILMA GROS (OWNER)
(225) 773-6581
Entity
Organization
Contact information
Practice address
321 NORTH CANAL BLVD, THIBODAUX, LA 70301-2988
(225) 265-6068
Mailing address
13246 DESIRE ST, VACHERIE, LA 70090-4328
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
09/30/2022
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