Organization
POMEGRANATE WELLNESS HEALTH AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PANSY HARRIS-LANE APN (OWNER)
(973) 731-6253
Entity
Organization
Contact information
Practice address
203 GIRARD RD N, GLASSBORO, NJ 08028-2117
(973) 731-6253
Mailing address
203 GIRARD RD N, GLASSBORO, NJ 08028-2117
(973) 731-6253
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/02/2019
Last updated
02/02/2019
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