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Prolactin Life, Llc

NPI Registration Record

Provider / OrganizationNPIDate Certified
PROLACTIN LIFE, LLC11044243652020-10-10
Entity TypeOrganization
Provider OrganizationPROLACTIN LIFE, LLC
Practice Office Address15012 NOTLEY RD
SILVER SPRING, MD US
Practice Office Telephone2403601205
Mailing Address15012 NOTLEY RD
SILVER SPRING, MD 209057437 US
Business Telephone2403601205
Authorized OfficialMARIANNE WYSONG, OWNER
2403601205
HPT Codes
CodeLicense NoState
163WL0100X PRIMARY
193400000X SINGGroup Code
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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