Healthcare Provider Details

I. General information

NPI: 1356275341
Provider Name (Legal Business Name): UNBREAKABLE BEAUTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 GLENDALE ST
DETROIT MI
48238-3212
US

IV. Provider business mailing address

4220 GLENDALE ST
DETROIT MI
48238-3212
US

V. Phone/Fax

Practice location:
  • Phone: 313-334-1826
  • Fax:
Mailing address:
  • Phone: 313-334-1826
  • Fax:

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: MS. IEISHA M WILLIAMS
Title or Position: CCPS
Credential: LPN
Phone: 313-334-1826