Healthcare Provider Details

I. General information

NPI: 1932949849
Provider Name (Legal Business Name): PRETTY HAIR ROCKZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7896 GEORGIA AVE
SILVER SPRING MD
20910-4859
US

IV. Provider business mailing address

2000 EAGLES LNDG WAY APT 303
ODENTON MD
21113-5210
US

V. Phone/Fax

Practice location:
  • Phone: 202-569-3255
  • Fax:
Mailing address:
  • Phone: 202-569-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name: RICKIA TAYLOR
Title or Position: OWNER
Credential:
Phone: 202-569-3255