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General NPI Number Information
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NPI Number | 1730877234
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Entity Type | Organization
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Legal Business Name | NYLAH ALEASE HAIR COLLECTION LLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 22725GREATER MACK AVE STE 301B PMB 501
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City | ST CLAIR SHORES
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State | MI
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Zip | 48080
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Country | US
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Telephone | 800-212-2682
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Fax |
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Provider Business Mailing Address
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Address Line | 22725GREATER MACK AVE STE 301B PMB 501
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City | ST CLAIR SHORES
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State | MI
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Zip | 48080
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Country | US
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Telephone | 800-212-2682
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Fax | 877-349-5853
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Authorized Official
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Title or Position | CRANIAL PROSTHESIS SPECIALIST
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Name | CANDICE HARRIS
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Credential |
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Telephone | 800-212-2682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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