Healthcare Provider Details

I. General information

NPI: 1265260392
Provider Name (Legal Business Name): ALL EYES ON YOU HAIR STUDIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5180 S 3RD ST
MEMPHIS TN
38109-6234
US

IV. Provider business mailing address

PO BOX 901091
MEMPHIS TN
38190-1091
US

V. Phone/Fax

Practice location:
  • Phone: 901-785-5878
  • Fax:
Mailing address:
  • Phone: 901-785-5878
  • 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: ZELLNER JONES STANDBACK
Title or Position: OWNER
Credential:
Phone: 901-785-5878