Organization
MY WIG STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMIN ACUNA BARNES (OWNER)
(909) 952-4935
Entity
Organization
Contact information
Practice address
12543 WINERY DR, RANCHO CUCAMONGA, CA 91739-8834
(909) 952-4935
Mailing address
12543 WINERY DR, RANCHO CUCAMONGA, CA 91739-8834
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/09/2014
Last updated
03/09/2014
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