Organization
KEITH'S HAIRCENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH MARLIN ZIMMERMAN (PRESIDENT)
(920) 499-3300
Entity
Organization
Contact information
Practice address
904 S MILITARY AVE, GREEN BAY, WI 54304-2115
(920) 499-3300
(920) 499-9404
Mailing address
904 S MILITARY AVE, GREEN BAY, WI 54304-2115
(920) 499-3300
(920) 499-9404
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
27014-080
WI
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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