Healthcare Provider Details

I. General information

NPI: 1851957872
Provider Name (Legal Business Name): MANE MEDIC HAIR REJUVENATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 N REYNOLDS RD
TOLEDO OH
43615-3514
US

IV. Provider business mailing address

2120 N REYNOLDS RD
TOLEDO OH
43615-3514
US

V. Phone/Fax

Practice location:
  • Phone: 419-407-5595
  • Fax:
Mailing address:
  • Phone: 419-407-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: TIMIKO KINER
Title or Position: PROSTHETIC ORTHOTIC SUPPLIER
Credential:
Phone: 419-690-5617