Healthcare Provider Details

I. General information

NPI: 1679374060
Provider Name (Legal Business Name): LUXE THE SALON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 E MONTGOMERY XRD
SAVANNAH GA
31406-4730
US

IV. Provider business mailing address

8 PINEBROOK CT
SAVANNAH GA
31405-8135
US

V. Phone/Fax

Practice location:
  • Phone: 912-201-1701
  • Fax:
Mailing address:
  • Phone: 912-208-7118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LATECKA S MOORE-EARLY
Title or Position: SALON OWNER
Credential:
Phone: 912-201-1701