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General NPI Number Information
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NPI Number | 1861783136
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Entity Type | Organization
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Legal Business Name | PAPILLA ALTERNATIVE HAIR INC.
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 3520 SEVEN BRIDGES DRIVE SUITE 240
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City | WOODRIDGE
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State | IL
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Zip | 60517
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Country | US
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Telephone | 630-724-9987
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Fax | 630-759-7784
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Provider Business Mailing Address
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Address Line | 3520 SEVEN BRIDGES DRIVE SUITE 240
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City | WOODRIDGE
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State | IL
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Zip | 60517
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Country | US
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Telephone | 630-724-9987
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Fax |
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Authorized Official
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Title or Position | COSMETOLEGIST
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Name | MRS. DEBRA J READ
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Credential |
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Telephone | 630-724-9987
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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 | 011162386
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License Number State | IL
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