Healthcare Provider Details

I. General information

NPI: 1508507534
Provider Name (Legal Business Name): XCEPTIONE BEAUTY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 04/05/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6821 1ST AVE N
BIRMINGHAM AL
35206-5018
US

IV. Provider business mailing address

459 MAIN ST # 387
TRUSSVILLE AL
35173-1416
US

V. Phone/Fax

Practice location:
  • Phone: 205-200-9423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MARQUITA RICKS JONES
Title or Position: CRANIAL PROSTHESIS SPECIALIST/OWNER
Credential:
Phone: 205-413-6127