Organization
JIRAH CREATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FELESHIA YVETTE WISE CERTIFIED HAIR LOSS (CEO)
(404) 840-6565
Entity
Organization
Contact information
Practice address
7285 MEADOW POINT DR, STONE MOUNTAIN, GA 30087-6350
(404) 840-6565
(770) 680-5563
Mailing address
7285 MEADOW POINT DR, STONE MOUNTAIN, GA 30087-6350
(404) 840-6565
(770) 680-5563
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
05/12/2014
Last updated
05/12/2014
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