Healthcare Provider Details

I. General information

NPI: 1487158002
Provider Name (Legal Business Name): AMBER R PERKINS HAIR LOSS SPECIALIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 03/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6217 RIME VILLAGE DR NW APT 202
HUNTSVILLE AL
35806-2785
US

IV. Provider business mailing address

6217 RIME VILLAGE DR NW APT 202
HUNTSVILLE AL
35806-2785
US

V. Phone/Fax

Practice location:
  • Phone: 256-213-8075
  • Fax:
Mailing address:
  • Phone: 256-213-8075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: