Organization
EMPORIUM BEAUTY SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENIA GRAYER (CRANIAL PROSTHESIS SPECIALIST)
(708) 527-9028
Entity
Organization
Contact information
Practice address
2023 RIDGE RD LOWR 1, HOMEWOOD, IL 60430-1783
(708) 527-9028
Mailing address
2023 RIDGE RD LOWR 1, HOMEWOOD, IL 60430-1783
(708) 527-9028
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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