Organization
THE W BEAUTY AND BARBER LOUNGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GABRIEL EPIPHANY WILSON (LICENSED COSMETOLOGISTS)
(313) 213-7443
Entity
Organization
Contact information
Practice address
18718 GRAND RIVER AVE, DETROIT, MI 48223-2215
(313) 340-2834
Mailing address
18718 GRAND RIVER AVE, DETROIT, MI 48223-2215
(313) 340-2834
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/21/2020
Last updated
01/21/2020
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