Healthcare Provider Details

I. General information

NPI: 1093467045
Provider Name (Legal Business Name): PURSUE 2 BEAUTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 SUNNYTHORN RD
MIDDLE RIVER MD
21220-4923
US

IV. Provider business mailing address

7929 EASTERN AVE
BALTIMORE MD
21224-2141
US

V. Phone/Fax

Practice location:
  • Phone: 410-936-4699
  • Fax:
Mailing address:
  • Phone: 410-936-4699
  • Fax: 443-420-9170

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: TRACY N HALL
Title or Position: PROSTHETIC / ORTHOTIC SUPPLIER
Credential:
Phone: 410-936-4699