MEDICARE: AC STYLES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1744P3200X	Prosthetics Case Management

General Provider Information

NPI Number	:	1710490172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AC STYLES LLC

Provider Business Mailing Address
First Line	:	PO BOX 201142
Second Line	:
City	:	SHAKER HTS
State	:	OH
Zip	:	44120-8102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4281 MORSE RD
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-1522
Country	:	US
Telephone Number	:	216-372-7699
Fax Number	:

Authorized Official
Title or Position	:	OWNER/HAIR LOSS SPECIALIST
Name	:	ALAINA CARR
Credential	:
Telephone Number	:	216-372-7699

Provider Enumeration Date	:	11/08/2017
Last Update Date	:	11/08/2017

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Directions to “AC STYLES LLC ” Practice Location

Language	Start Address	Practice Location

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