Healthcare Provider Details

I. General information

NPI: 1124735451
Provider Name (Legal Business Name): ABOUT FACE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 SHALLOWFORD RD STE 101
CHATTANOOGA TN
37421-7803
US

IV. Provider business mailing address

6151 SHALLOWFORD RD STE 101
CHATTANOOGA TN
37421-7803
US

V. Phone/Fax

Practice location:
  • Phone: 423-505-3223
  • Fax:
Mailing address:
  • Phone: 423-505-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZA2600X
TaxonomyMedical Art Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: ROBIN HAYS
Title or Position: TECHNICIAN
Credential: CPCP
Phone: 423-505-3223