Organization
THE LACE WIG STORE AND SALON, LLC
Active
Organization
THE LACE WIG STORE AND SALON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DONNA RENA SINGLETON CRANIAL PROSTHESIS (OWNER)
(251) 300-8036
Entity
Organization
Contact information
Practice address
3202 DAUPHIN ST, MOBILE, AL 36606-4001
(251) 300-8036
Mailing address
3202 DAUPHIN ST, MOBILE, AL 36606-4001
(251) 300-8036
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
012455
AL
Other
Enumeration date
06/08/2009
Last updated
10/18/2012
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