Organization · NPI-2
1st Impression Salon LLC
Specialist, Prosthetics Case Management · Upper Darby, PA
NPI number1134620503
StatusActive
Last updated in NPPESFeb 23, 2018
Details
- NPI
- 1134620503
- Entity type
- Organization (NPI-2)
- Legal business name
- 1st Impression Salon LLC
- Organization subpart
- No
- Enumeration date
- Feb 21, 2018
- Last updated
- Feb 23, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1744P3200X | Specialist, Prosthetics Case Management | – | – | Yes |
| 1744P3200X | Specialist, Prosthetics Case Management | CT020639L | PA |
Practice location
6818 Market StUpper Darby, PA 19082-2439
Phone 267-970-3888
Mailing address
6818 Market StUpper Darby, PA 19082-2439
Phone 267-970-3888
Authorized official
Zakiyyah Suluki
Owner
2679703888
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