Organization
XCLUSIVELY BRANDED DBA FEDORA'S LUXE MEDICAL WIGS
Active
Organization
XCLUSIVELY BRANDED DBA FEDORA'S LUXE MEDICAL WIGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FEDORA MCGILL (MANAGER)
(843) 956-7131
Entity
Organization
Contact information
Practice address
117 N MCALLISTER ST, LAKE CITY, SC 29560-2421
(843) 956-7131
Mailing address
117 N MCALLISTER ST, LAKE CITY, SC 29560-2421
(843) 956-7131
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/02/2025
Last updated
10/03/2025
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