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General NPI Number Information
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NPI Number | 1639951411
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE HAIR CENTER
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 2245 S. ORTONVILLE RD
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City | ORTONVILLE
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State | MI
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Zip | 48462
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Country | US
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Telephone | 248-625-6560
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Fax |
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Provider Business Mailing Address
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Address Line | 2245 S. ORTONVILLE RD.
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City | ORTONVILLE
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State | MI
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Zip | 48462
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Country | US
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Telephone | 248-625-6560
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KAREN HENCKEL
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Credential |
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Telephone | 248-625-6560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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