Coeur D'alene Wigs LLC

NPI #1558931691 in Coeur D Alene, Idaho

Provider Information

NPI Number: 1558931691
Entity Type: Organization
Organization Name: Coeur D'alene Wigs LLC
Primary Specialty: Prosthetist
Enumeration Date: Jun 30, 2021
Last Updated: Jun 30, 2021

Practice Location

Address: 296 W SUNSET AVE STE 17
City: Coeur D Alene
State: Idaho
ZIP Code: 83815-8367
Phone: (208) 551-2761

Authorized Official

Name: MRS. JENNIFER LYNN LINDLEY
Title: OWNER/PARTNER
Phone: (208) 551-2761

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prosthetist	224P00000X	Primary

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