Healthcare Provider Details

I. General information

NPI: 1295427037
Provider Name (Legal Business Name): BRAIDZ&BEAUTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 POWDER SPRINGS RD SW STE 1219
MARIETTA GA
30064-4568
US

IV. Provider business mailing address

2665 FAVOR RD SW # 2I02
MARIETTA GA
30060-5237
US

V. Phone/Fax

Practice location:
  • Phone: 513-882-2607
  • Fax:
Mailing address:
  • Phone: 513-882-2607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: EVELYN WEST
Title or Position: CEO
Credential: SPECIALIST
Phone: 513-882-2607