Healthcare Provider Details

I. General information

NPI: 1023589777
Provider Name (Legal Business Name): STYLZPLUS BEAUTY AND HAIR CONCEPTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 PLANTATION CENTER DR STE 203
RALEIGH NC
27616-5190
US

IV. Provider business mailing address

6350 PLANTATION CENTER DR STE 203
RALEIGH NC
27616-5190
US

V. Phone/Fax

Practice location:
  • Phone: 919-833-2447
  • Fax:
Mailing address:
  • Phone: 919-833-2447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name: AVION NELSON HUNTER
Title or Position: EXECUTIVE DIRECTOR
Credential: COSMETOLOGIST
Phone: 919-833-2447