Organization
NEW IMAGE RX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMEKA DESHAWN TAYLOR (CERTIFIED HAIR LOSS SPECIALIST)
(804) 318-1031
Entity
Organization
Contact information
Practice address
4209 W HUNDRED RD, CHESTER, VA 23831-1734
(804) 318-1031
(804) 318-1042
Mailing address
4209 W HUNDRED RD, CHESTER, VA 23831-1734
(804) 318-1031
(804) 318-1042
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/28/2016
Last updated
01/19/2021
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