Healthcare Provider Details
I. General information
NPI: 1922514439
Provider Name (Legal Business Name): CURL-UP & RELAX SALON AND HAIR LOSS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3236 WILCOX BLVD
CHATTANOOGA TN
37411-1071
US
IV. Provider business mailing address
3236 WILCOX BLVD
CHATTANOOGA TN
37411-1071
US
V. Phone/Fax
- Phone: 423-595-0652
- Fax:
- Phone: 423-595-0652
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1744P3200X |
| Taxonomy | Prosthetics Case Management |
| License Number | |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1744P3200X |
| Taxonomy | Prosthetics Case Management |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
JOSEPHINE
P
ODOM
Title or Position: OWNER/SPECIALIST
Credential: CERTIFIED HAIR LOSS
Phone: 423-595-0652