Organization
HAIR REPLACEMENT CLINIC
Active
Parent organization
HAIR REPLACEMENT CLINIC
Other names
Derita Strong
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAIR REPLACEMENT CLINIC
Authorized official
DERITA JOH'NAY STRONG HAIR REPLACEMENT (SPECIALIST/OWNER)
(316) 390-1280
Entity
Organization
Contact information
Practice address
1815 S WINDSOR, WICHITA, KS 67218
(316) 390-1280
Mailing address
1815 S WINDSOR, WICHITA, KS 67218
(316) 390-1280
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
29647
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9860
—
KS
Enumeration date
08/17/2016
Last updated
08/17/2016
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