Individual
LEOLA MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
470 KNOLLWOOD ST, WINSTON SALEM, NC 27103-3426
(336) 986-9063
Mailing address
PO BOX 11762, WINSTON SALEM, NC 27116-1762
(336) 918-8521
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/13/2022
Last updated
12/29/2022
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