Provider Demographics
NPI:1003438177
Name:TOSI'S HAIR REPLACEMENT CLINIC, INC.
Entity type:Organization
Organization Name:TOSI'S HAIR REPLACEMENT CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KITHCART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-574-5961
Mailing Address - Street 1:390 SLOCUM AVE
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:PA
Mailing Address - Zip Code:18643-1194
Mailing Address - Country:US
Mailing Address - Phone:570-693-3276
Mailing Address - Fax:570-693-4267
Practice Address - Street 1:390 SLOCUM AVE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:PA
Practice Address - Zip Code:18643-1194
Practice Address - Country:US
Practice Address - Phone:570-693-3276
Practice Address - Fax:570-693-4267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier