Organization
THE WIG THERAPIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMILA JOHNSON (OWNER.CPS)
(908) 793-8556
Entity
Organization
Contact information
Practice address
508 W 5TH AVE, ROSELLE, NJ 07203-2330
(908) 793-5565
Mailing address
508 W 5TH AVE, ROSELLE, NJ 07203-2330
(908) 793-5565
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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