NPI 1447860150

Shadae Renee Medical Wigs

Organisation Prosthetic/Orthotic Supplier Roswell, GA

Practice location

Address: 10719 Alpharetta Hwy # 1792, Roswell, GA 30076-2432
Phone: (678) 362-6469
Fax: (678) 325-2731

Authorised official

Name: Shadae Green
Title: Owner
Phone: (678) 362-6469

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

Other Prosthetic/Orthotic Supplier providers in Georgia →

Registry record

NPI: 1447860150
Entity type: Organization
NPI issued: 6 Aug 2020
Record last updated: 6 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.