Organization
RACOLE EXTENSIONS, L.C.
Active
Other names
Salon M double U
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LA'SONIA NICOLE NICK-MCGRIFF (OWNER)
(240) 304-0865
Entity
Organization
Contact information
Practice address
2455 ANNAPOLIS MALL, ANNAPOLIS, MD 21401-7613
(410) 379-5310
Mailing address
2455 ANNAPOLIS MALL, ANNAPOLIS, MD 21401-7613
(410) 379-5310
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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