Organization
ROYAL GLYTZ HAIR REPLACEMET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEISHA HARDAWAY (OWNER)
(910) 849-4422
Entity
Organization
Contact information
Practice address
500 N REILLY RD STE 122, FAYETTEVILLE, NC 28303-2452
(910) 849-4422
Mailing address
500 N REILLY RD STE 122, FAYETTEVILLE, NC 28303-2452
(910) 849-4422
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
C88537
NC
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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