Organization
TOTAL TRANSFORMATION VIRGIN HAIR
Active
Other names
Total Transformation Virgin Hair
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY L WOODSON (OWNER/PERRUQUIER)
(616) 726-0193
Entity
Organization
Contact information
Practice address
2035 28TH ST SE STE D, GRAND RAPIDS, MI 49508-1549
(616) 719-0401
Mailing address
2035 28TH ST SE STE D, GRAND RAPIDS, MI 49508-1549
(616) 719-0401
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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