Organization
THE WIG SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDYCE S SLADE (OWNER)
(502) 412-8810
Entity
Organization
Contact information
Practice address
9960 LINN STATION RD, LOUISVILLE, KY 40223
(502) 412-8810
(502) 394-0783
Mailing address
9960 LINN STATION RD, LOUISVILLE, KY 40223
(502) 412-8810
(502) 394-0783
Taxonomy
Speciality
Code
Description
License number
State
229N00000X
Anaplastologist
Primary
246536
KY
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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