Healthcare Provider Details

I. General information

NPI: 1326976960
Provider Name (Legal Business Name): LARUE'S HAIR STUDIO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1092 EAGLES LANDING PKWY
STOCKBRIDGE GA
30281-5012
US

IV. Provider business mailing address

950 EAGLES LANDING PKWY STE 970
STOCKBRIDGE GA
30281-7343
US

V. Phone/Fax

Practice location:
  • Phone: 404-934-0395
  • Fax:
Mailing address:
  • Phone: 404-934-0395
  • 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: TINA KENDALL
Title or Position: OWNER / CEO
Credential:
Phone: 404-934-0395